Abdominal pain and vomiting are frequently encountered in the emergency department. We report a 54-year-old man with an uncommon cause of intestinal obstruction – superior mesenteric artery syndrome – who presented with epigastric pain and vomiting. Diagnosis is clinical with radiological confirmation by upper gastrointestinal series or computed tomography scan. Most patients respond to conservative and supportive treatment. A minority may need surgical intervention.

Noisy belching in front of other people, often considered to be an impolite manner, may not be as harmless as it seems. We report on a patient who had spontaneous pneumomediastinum after intentional induction of noisy belching by rapid excessive intake of carbonated drinks (imitating the game played in a popular local television program “The Super Trio Continues…”). The clinical features, investigations and management of spontaneous pneumomediastinum are discussed.

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