Hamman syndrome, also known as Macklin syndrome, refers to spontaneous pneumomediastinum with subcutaneous emphysema.
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Epidemiology
It is a rare entity most often encountered in young adults, particularly in the peri- and postpartum periods 3.
Clinical presentation
Hamman syndrome is most commonly asymptomatic. Presenting symptoms include:
non-specific chest pain
dyspnea
dysphonia
subfebrile temperature
Interestingly, clinical examination may demonstrate the Hamman sign, a pulse-synchronous rasping sound that is believed to be caused by pneumopericardium.
Pathology
It is most commonly idiopathic (i.e. cryptogenic) in nature or due to barotrauma (see Macklin effect). This is accounted for by the increased intrathoracic pressure associated with asthma and the peripartum period.
Radiographic features
See main article: pneumomediastinum. In rare cases, pneumorrhachis may also be encountered.
Treatment and prognosis
Complications
a concomitant pneumothorax may also be present in some cases 5
History and etymology
The syndrome is named after clinician Louis Virgil Hamman (1877-1946) who described it in 1939 1.
Differential diagnosis
It has to be distinguished from more sinister pathology or entities, e.g. Boerhaave syndrome, as the clinical course of Hamman syndrome is usually benign and self-limiting, and as such, management is often conservative 3.