The patients sometimes present in moderate distress with epigastric pain and bleeding. Patients may experience tachycardia, weak pulse, hypotension, diaphoresis and fever.

• Physical examination is usually not helpful, particularly early in the course.^{[1][2][3][4][5]}
• Subcutaneous emphysema (crepitation) is an important diagnostic finding but is not very sensitive, being present in only 9 of 34 patients (27 percent) in one series.
• A pleural effusion may be occur and be associated with an Enterococcal bacterial pericardial effusion.

The patient might be in moderate distress with epigastric pain and bleeding.

• Tachycardia
• Weak pulse
• Hypotension
• Diaphoresis
• Fever

• Pallor

• Normal

• Low Jugular venous pressure

• Subcutaneous emphysema
• Pneumomediastinum may cause a crackling sound on chest auscultation, known as the Hamman’s crunch.

• Tachycardia

• Abdominal rigidity

• Normal

• Normal

• Normal

• Normal