Ah… AHHH… Choose wisely when it comes to handling that impending sneeze. Holding one in can lead to some serious damage, British doctors report Monday in BMJ Case Reports.

In their rare-disease case report, they relay the tale of an otherwise healthy 34-year-old male who managed to tear a hole in the back of his throat trying to extinguish a snot explosion.

The man showed up in an emergency room with an alarming popping sensation and swelling in his throat. He was also in terrible pain and could barely talk. Subsequent X-rays and CT scans revealed that he had bubbles of air throughout his neck, including along his spine. The doctors also noted a crackling, grating sound coming from both sides of his throat down to his chest, which is a sign of gas trapped inside tissue.

Though it appeared that air was escaping his throat, the man denied having eaten anything sharp that may have punctured his pipes. Instead, the man explained that right before the problem started he had stifled a sneeze by pinching his nose closed and clenching his mouth shut.

Typically, such throat tears are due to forceful coughing, retching, or vomiting, not halted achoos. Nevertheless, the doctors determined that the squelched sneeze had perforated his pharynx. They promptly admitted the man to the hospital. They installed a nasogastric feeding tube and gave him prophylactic intravenous antibiotics.

The man recovered in a week and at a two-month follow-up showed no further problems or complications.

The doctors conclude that “Halting sneeze via blocking nostrils and mouth is a dangerous maneuver and should be avoided, as it may lead to numerous complications.” These include trapped air, broken pipes, or even rupture of a cerebral aneurysm. In other words, holding in a sneeze is nothing to sneeze at.

BMJ Case Reports, 2018. DOI: 10.1136/bcr-2016-218906 (About DOIs).