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Images In Medicine
doi: 10.4103/0970-258X.314008
PMID: 33904425

Hamman syndrome

J Sankar1 , Maneesh Uniyal2 , Kishore Kumar3
1 Department of Medicine, Military Hospital, Chennai, Tamil Nadu, India
2 Department of Radiodiagnosis, Military Hospital, Chennai, Tamil Nadu, India
3 Department of Medicine and Oncology, Command Hospital, Bengaluru, Karnataka, India

Corresponding Author:
J Sankar
Department of Medicine, Military Hospital, Chennai, Tamil Nadu
Published: 17-Apr-2021
How to cite this article:
Sankar J, Uniyal M, Kumar K. Hamman syndrome. Natl Med J India 2020;33:180
Copyright: (C)2020 The National Medical Journal of India

A 19-year-old male, without any previous comorbid conditions, presented to the emergency department with a history of swelling in the neck, hoarseness of voice and fever for 1 day. Clinically, he had tachycardia, and there was crepitation in the neck and anterior chest wall on palpation. His past medical history was non-contributory, and he was not on any medication. He denied any history of trauma, surgery or any medical procedure. On chest X-ray posteroanterior view, subcutaneous emphysema was confirmed. Non-contrast computed tomography of the chest showed mediastinal and subcutaneous emphysema but no pneumothorax [Figure - 1] and [Figure - 2]. Bronchoscopy and oesophagoscopy revealed no abnormality. Electrocardiogram showed sinus tachycardia. He was observed in the intensive care unit on 100% oxygen support, and the subcutaneous emphysema gradually resolved over 72 hours. Hamman syndrome (spontaneous pneumomediastinum presenting as subcutaneous emphysema), often idiopathic, is a rare clinical entity. Its incidence is <1:44 000, with a male predominance.[1] Patients can present with thoracic pain, dyspnoea, swelling in the neck, dysphagia, fever or hoarseness of voice. Conservative management is required with follow-up.[2] It is a benign entity with good prognosis. Drainage of subcutaneous air by a microdrainage catheter or skin incisions may be required in symptomatic patients with respiratory distress.

Figure 1: X-ray neck lateral view showing subcutaneous emphysema
Figure 2: Non-contrast computed tomography chest showing subcutaneous emphysema and pneumomediastinum

Conflict of interest. None declared

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