Introduction: Pneumomediastinum is a rare condition characterized by the presence of air in the mediastinal space. Hamman's syndrome, an affliction that arises from disparate pressures within the pulmonary interstitium and alveoli, often manifests subsequent to the Valsalva maneuver. The crepitation perceived during systolic contraction, a phenomenon known as Hamman's sign, constitutes a pivotal element in the diagnostic process.
Case Description: A 22-year-old male patient presented to the emergency department with atypical chest tightness and dyspnea that began after singing. Cardiac auscultation revealed crepitation in the precordial area. Chest X-ray revealed air densities around the trachea. Given the absence of esophageal or bronchial rupture, in conjunction with the presence of Hamman's sign, a diagnosis of Hamman's syndrome was established. The patient was discharged after undergoing follow-up.
Conclusion: Since a serious condition such as Hamman syndrome may develop even in dyspnea that develops after daily activity, necessary investigation and treatment should be performed.
REFERANCES
1) Macklin CC. Transport of air along sheaths of pulmonic blood vessels from alveoli to mediastinum: clinical implications. Arch Intern Med 1939;64(5):913.
2) Peña-Vega CJ, Buitrón-García R, Zavala-Barrios B, et al. Postpartum Hamman (pneumomediastinal) syndrome. Synthesis of the literature and case report. Ginecol Obstet Mex. 2023;91(03):197-209.
3) Cox GT, Bowles MB, Ng J, Townend P, Rutherford L, Parker D: A storm or a storm in a teacup? A retrospective review of spontaneous pneumomediastinum at a tertiary Australian Hospital. Int Surg J. 2023,10:542-7.
4) Ebina M, Inoue A, Takaba A, Arioshi K. Management of spontaneous pneumomediastinum: are hospitalization and prophylactic antibiotics needed? Am J Emerg Med 2017;35(8):1150–3.
5) Song IH, Lee SY, Lee SJ, Choi WS. Diagnosis and treatment of spontaneous pneumomediastinum: experience at a single institution for 10 years. Gen Thorac Cardiovasc Surg 2017;65(5):280–4.
6) Hamman LV . Spontaneous mediastinal emphysema. Bull Johns Hopkins Hosp 1939;64:1–21 .
7) Jones R, Kundrotas L: "HOOAH!" A case of pneumomediastinum in the military training environment; Hamman's sign 71 years later. Mil Med. 2011, 176:352-5.
8) Morgan CT, Maloney JD, Decamp MM, McCarthy DP. A narrative review of primary spontaneous pneumomediastinum: a poorly understood and resource-intensive problem. J Thorac Dis 2021;13(6):3721–30.
9) Kim KS, Jeon HW, Moon Y, Kim YD, Ahn MI, Park JK, Jo KH: Clinical experience of spontaneous pneumomediastinum: diagnosis and treatment. J Thorac Dis. 2015, 7:1817-24.
10) Beynon F, Mearns S: Spontaneous pneumomediastinum following normal labour . BMJ Case Rep. 2011, 2011:bcr0720114556.
11) Sadarangani S, Patel DR, Pejka S: Spontaneous pneumomediastinum and epidural pneumatosis in an adolescent precipitated by weight lifting: a case report and review. Phys Sportsmed. 2009, 37:147-53.
12) Kara H, Bayir A, Ak A, Degirmenci S, Akinci M, Zorlu A. Spontaneous pneumomediastinum in a young man. BMJ Case Rep. 2013;2013.
13) Raptopoulos V, Davis S, Bode H. Spontaneous pneumomediastinum: clinical and roentgenographic features. AJR Am J Roentgenol. 1982;139(4):629-632.
14) Singla M, Potocko J, Sanstead J, Pepper P. Ooh-rah! An unusual cause of spontaneous pneumomediastinum. Mil Med. 2012 Nov;177(11):1396-8. doi: 10.7205/milmed-d-12-00243. PMID: 23198520.
15) Yamairi K, Yoshimatsu Y, Shimazu H, et al.: Clinical analysis of 71 spontaneous pneumomediastinum cases: an observational study from a tertiary care hospital in Japan. Respir Investig. 2021, 59:530-4.
16) Shine NP, LacyP,Conlon B, McShaneD. Spontaneous retropharyngeal and cervical emphysema: a rare singer’s injury.EarNoseThroat J 2005; 84:726–7.
Giriş: Pnömomediastinum, mediastinal boşlukta hava varlığıyla karakterize nadir bir durumdur. Akciğerler arası boşluk ve alveollerdeki farklı basınçlardan kaynaklanan bir rahatsızlık olan Hamman sendromu, genellikle Valsalva manevrasından sonra ortaya çıkar. Sistolik kasılma sırasında algılanan, Hamman belirtisi olarak bilinen bir fenomen olan krepitasyon, tanı sürecinde önemli bir unsur oluşturur.
Vaka Tanımı: 22 yaşında erkek hasta, şarkı söyledikten sonra başlayan atipik göğüs sıkışması ve dispne ile acil servise başvurdu. Kardiyak oskültasyonda prekordiyal bölgede krepitasyon görüldü. Göğüs röntgeninde trakea çevresinde hava yoğunlukları görüldü. Özofageal veya bronşiyal rüptürün olmaması ve Hamman belirtisinin varlığı göz önüne alındığında, Hamman sendromu tanısı konuldu. Hasta takipten geçtikten sonra taburcu edildi.
Sonuç: Günlük aktivite sonrası gelişen dispnede bile Hamman sendromu gibi ciddi bir durum gelişebileceğinden gerekli tetkik ve tedavi yapılmalıdır.
REFERANCES
1) Macklin CC. Transport of air along sheaths of pulmonic blood vessels from alveoli to mediastinum: clinical implications. Arch Intern Med 1939;64(5):913.
2) Peña-Vega CJ, Buitrón-García R, Zavala-Barrios B, et al. Postpartum Hamman (pneumomediastinal) syndrome. Synthesis of the literature and case report. Ginecol Obstet Mex. 2023;91(03):197-209.
3) Cox GT, Bowles MB, Ng J, Townend P, Rutherford L, Parker D: A storm or a storm in a teacup? A retrospective review of spontaneous pneumomediastinum at a tertiary Australian Hospital. Int Surg J. 2023,10:542-7.
4) Ebina M, Inoue A, Takaba A, Arioshi K. Management of spontaneous pneumomediastinum: are hospitalization and prophylactic antibiotics needed? Am J Emerg Med 2017;35(8):1150–3.
5) Song IH, Lee SY, Lee SJ, Choi WS. Diagnosis and treatment of spontaneous pneumomediastinum: experience at a single institution for 10 years. Gen Thorac Cardiovasc Surg 2017;65(5):280–4.
6) Hamman LV . Spontaneous mediastinal emphysema. Bull Johns Hopkins Hosp 1939;64:1–21 .
7) Jones R, Kundrotas L: "HOOAH!" A case of pneumomediastinum in the military training environment; Hamman's sign 71 years later. Mil Med. 2011, 176:352-5.
8) Morgan CT, Maloney JD, Decamp MM, McCarthy DP. A narrative review of primary spontaneous pneumomediastinum: a poorly understood and resource-intensive problem. J Thorac Dis 2021;13(6):3721–30.
9) Kim KS, Jeon HW, Moon Y, Kim YD, Ahn MI, Park JK, Jo KH: Clinical experience of spontaneous pneumomediastinum: diagnosis and treatment. J Thorac Dis. 2015, 7:1817-24.
10) Beynon F, Mearns S: Spontaneous pneumomediastinum following normal labour . BMJ Case Rep. 2011, 2011:bcr0720114556.
11) Sadarangani S, Patel DR, Pejka S: Spontaneous pneumomediastinum and epidural pneumatosis in an adolescent precipitated by weight lifting: a case report and review. Phys Sportsmed. 2009, 37:147-53.
12) Kara H, Bayir A, Ak A, Degirmenci S, Akinci M, Zorlu A. Spontaneous pneumomediastinum in a young man. BMJ Case Rep. 2013;2013.
13) Raptopoulos V, Davis S, Bode H. Spontaneous pneumomediastinum: clinical and roentgenographic features. AJR Am J Roentgenol. 1982;139(4):629-632.
14) Singla M, Potocko J, Sanstead J, Pepper P. Ooh-rah! An unusual cause of spontaneous pneumomediastinum. Mil Med. 2012 Nov;177(11):1396-8. doi: 10.7205/milmed-d-12-00243. PMID: 23198520.
15) Yamairi K, Yoshimatsu Y, Shimazu H, et al.: Clinical analysis of 71 spontaneous pneumomediastinum cases: an observational study from a tertiary care hospital in Japan. Respir Investig. 2021, 59:530-4.
16) Shine NP, LacyP,Conlon B, McShaneD. Spontaneous retropharyngeal and cervical emphysema: a rare singer’s injury.EarNoseThroat J 2005; 84:726–7.
Birincil Dil | İngilizce |
---|---|
Konular | Acil Tıp, Göğüs Hastalıkları |
Bölüm | Case Report |
Yazarlar | |
Yayımlanma Tarihi | 30 Eylül 2025 |
Gönderilme Tarihi | 28 Nisan 2025 |
Kabul Tarihi | 4 Haziran 2025 |
Yayımlandığı Sayı | Yıl 2025 Cilt: 16 Sayı: 3 |