Predispozan Sebebi Bulunmayan Hamman Sendromu Gelişen Genç Kadın Olgu

Abstract

Pnömomediastinum, mediasten içerisinde hava bulunmasıdır; primer (spontan) ve sekonder olarak iki ana gruba ayrılır. Spontan pnömomediastinumda, sekonder pnömediastinumdan farklı olarak mediastendeki serbest havayı açıklayacak direkt bir sebep bulunmaz. Astım, KOAH, kokain kullanımı gibi birkaç predispozan faktörler tanımlanmıştır. Ancak 1/3 oranında hastada hiçbir etyolojik faktör tanımlanamamıştır ve bu idiopatik grubu oluşturur. Bu durum daha çok genç erkeklerde görülür (erkek/kadın=4/1). Pnömomediastinuma subkutan amfizemin eşlik etmesi, Hamman sendrumu olarak bilinmektedir. Bu hastalar sıklıkla acil servise göğüs ağrısı ve nefes darlığı ile başvurmaktadırlar. Bizim olgumuz ise 19 yaşında kadın hasta ise göğüs ağrısı olmaksızın nefes darlığı ile acil servisimize başvurmuştur. Posterioanterior(PA) akciğer grafisinde ve bilgisayarlı tomografi görüntülerinde pnömomediastinum, boyun kompartmanlarında ve subkutan dokularda amfizem tespit edilmiştir. Hamman sendromlu hastalarda beklendiği üzere, olgumuzun klinik tablosu semptomatik tedaviler sonrasında gerilemiş olup bu süreçte herhangi bir komplikasyon gelişmemiştir.

Keywords

• hamman sendromu
• spontan pnömomediastinum
• subkutan amfizem

A Young Female Case With Hamman Syndrome Without Any Predisposing Factor

Abstract

Pneumomediastinum is, by definition the precens of air in the mediastinum and divided into two main groups: primary (spontaneous) and secondary. In spontaneous pneumomediastinum, unlike the secondary pneumediastinum, there is no direct reason to explain the free air in the mediastinum. Several predisposing factors such as asthma, COPD, cocaine use have been identified. However, no etiological factor has been identified in 1/3 of the patients which constitutes the idiopathic group. This condition is mostly seen in young asthenic men (male / female = 4/1). The accompanying subcutaneous emphysema with pneumomediastinum is known as the Hamman syndrome. These patients frequently refer to the emergency department with chest pain and shortness of breath. In our case, a 19-year-old female patient referred to our emergency department with shortness of breath without evident chest pain. Posterioanterior (PA) chest radiograph and computed tomography images revealed pneumomediastinum with emphysema in the cervical compartments and subcutaneous tissues. As expected in the patients with Hamman syndrome, the clinical condition of the patient improved with symptomatic treatments and no complications developed during the course of the disease.

Keywords

• hamman syndrome
• spontaneous pneumomediastinum
• subcutaneous emphysema

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