Postpartum spontaneous pneumomediastinum 'Hamman's syndrome'

Abstract

Spontaneous pneumomediastinum and subcutaneous emphysema (Hamman's syndrome) are rare but potentially dangerous complications of labour. The authors reported a case of a 23-year-old primigravida, admitted to our hospital for delivery after 40 weeks of pregnancy. She delivered a baby of 4.27 kg after 9 h from the start of labour. A few minutes after delivery, the patient developed dyspnoea and chest tightness, which made her doctor suspect pulmonary embolism. A chest X-ray and CT scan revealed pneumomediastinum and subcutaneous emphysema. The patient had been followed up for 3 days in our hospital, without specific therapy.

Figure 1

Initial chest X-ray showing a pneumomediastinum and subcutaneous emphysema.

Figure 2

(A) CT scan of the chest showing free air in the mediastinum and in interstitial tissue (white arrow). (B) CT scan of the chest showing the pneumomediastinum displacing the vascular structures of the mediastinum, with extensive subcutaneous emphysema (asterisks). (C) Coronal reconstruction showing the pneumomediastinum. (D) Sagittal reconstruction showing free air under pleura interstitial tissue (white arrow).

Figure 3

Chest X-ray of second day showing the clear regression of subcutaneous emphysema.