In the first known case, a man has torn his windpipe while trying to hold in a sneeze. The incident happened when the man was driving his car and experiencing a bout of hay fever.

Suddenly, he felt the overwhelming urge to sneeze, however instead of letting the sneeze loose, he pinched his nose and closed his mouth to stifle the sneeze.

After the man started experiencing extreme pain, his neck was swollen on both sides and he struggled to move it, he was rushed to the emergency department of a hospital. According to a report by Live Science, the doctors could also hear a faint crackling sound during examination. However, the man didn’t have any issues breathing, swallowing or talking.

Reportedly, the X-ray revealed the man had surgical emphysema. It is a condition in which air gets trapped under the deepest tissue layers below the skin. Moreover, a CT scan then showed that the tear was between the third and fourth bones, or vertebrae, of his neck. Additionally, air had also accumulated in the space in the chest between his lungs.

The man was monitored at the hospital for two days to ensure his oxygen levels and other vital signs remained steady. He was then discharged and he was prescribed pain-relief and hay fever medications. He was also asked to avoid any strenuous physical activity for two weeks. Five weeks later, a CT scan revealed that the tear was healed.

The team of doctors presented the findings of this rare case in the journal BMJ Case Reports and it was published earlier this month. The doctors emphasised that the case should be a warning to others.

“Everyone should be advised not to stifle sneezes by pinching the nose while keeping the mouth closed as it can result in tracheal [windpipe] perforation,” the case report authors wrote.

According to the authors, spontaneous tearing of the windpipe is rare but potentially fatal. “Only a few cases have ever been reported, and they’re usually caused by physical trauma or injuries following a medical procedure, such as surgical removal of the thyroid gland or insertion of a tube into the windpipe. Depending on where the tear is and whether a patient’s vital signs are stable, surgery is usually needed to repair the damage,” the case report authors wrote.