Hamman syndrome

Last revised by Joshua Yap on 1 May 2023

Hamman syndrome, also known as Macklin syndrome, refers to spontaneous pneumomediastinum with subcutaneous emphysema.

It is a rare entity most often encountered in young adults, particularly in the peri- and postpartum periods 3.

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.

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.

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

  • a concomitant pneumothorax may also be present in some cases 5

The syndrome is named after clinician Louis Virgil Hamman (1877-1946) who described it in 1939 1.

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.

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