Hamman syndrome in an 18-year-old male patient

Abstract

In 1939, Hamman´s syndrome, also know as spontaneous pneumomediastinum, was characterized by the presence of pneumothorax, subcutaneous emphysema, and pneumorrhachis. It is believed to arise from barotrauma during vaginal labor, causing alveolar membrane rupture and subsequent air leakage. Clinical manifestations are often nonspecific. Management strategies vary based on symptom severity and complications, high-concentrations oxygen therapy promoting air absorption. We present the case of an 18-year-old male patient with a history of bronchial asthma and tobacco use, underscoring the need for heightened awareness of Hamman´s syndrome in similar cases. Prompt diagnosis and appropriate management are crucial to prevent or quickly address potential life-threatening complications. Diagnosing this syndrome in male patients can be particularly challenging, as it was initially associated with complications from vaginal labor, potentially leading to poorer outcomes.

Figure 1. Chest X-ray at admission. A. Evidence of cervical and thoracic subcutaneous emphysema predominantly in the anterior region (large arrow). B. Pneumomediastinum extending into the deep cervical planes and pneumomediastinum (smaller arrows).

Figure 2. Neck computed tomography without contrast at admission. Extensive emphysema dissecting the anterior and posterior superficial and deep cervical spaces. Mucosal thickening and air-fluid levels in paranasal sinuses indicate inflammation, along with pneumorrhachis (arrow).

Figure 3. Follow-up non-contrast chest computed tomography on Day 5. Extensive emphysema is observed in the muscular and adipose planes of the cervicothoracic region, along with moderate pneumomediastinum (arrows) and minimal bilateral basal pneumothorax.