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A couple of experiences:
I had this happen in a collge game last year. The two players going for the rebound had been working hard against each other for the first several minutes of the second half. Nothing outside the lines, just bigs being bigs. Anyway, the defensive player gets the rebound, looks back and, in my opinion, measures the other player and swings an elbow that connects with the players throat. The player is taken off their feet by the contact. TWEET! I had my choice (intentional/flagrant). My call was flagrant based on the entire result of the act. No one even thought twice about it.
In another game, before the change in penalties included a violation, a player was being tightly defended when the offense made contact, nothing severe, but surely a call (PC)needed to be made to reinforce that swinging elbows is not something that will continue. Again, no one took issue with the call and the rest of the game went off without difficulty.
Not all situations are exactly the same, but having seen the plays in their entirety certainly makes all the difference in the call that you make.
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