Revision 18 for 'Hamman syndrome'

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Hamman syndrome

Hamman syndrome, (or Macklin syndrome), refers to spontaneous pneumomediastinum along with subcutaneous emphysema.

Epidemiology

It is a rare entity most often encountered in young adults. It is a known entity peri- and postpartum 3.

Clinical presentation

The condition is most commonly asymptomatic. Presenting symptoms can include

  • non-specific chest pain 
  • dyspnea
  • dysphonia
  • subfebrile temperature

Interestingly, possible signs on clinical examination contain Hamman sign, a pulse-synchronous rasping sound which is believed to be caused by pneumopericardium.

Pathology

Most commonly idiopathic (i.e. cryptogenic) nature. Pathomechanism is barotrauma (see main article: Macklin effect). This accounts for the association of asthma and the peripartum period causing increased intrathoracic pressures.

Radiographic features

See main article: pneumomediastinum. In rare cases, pneumorrhachis may be encountered.

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.

See also

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