Hamman syndrome, also known as Macklin syndrome, refers to spontaneous pneumomediastinum along with subcutaneous emphysema.
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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 include the Hamman sign, a pulse-synchronous rasping sound which is believed to be caused by pneumopericardium.
Pathology
Most commonly idiopathic (i.e. cryptogenic) in nature. The pathomechanism is barotrauma (see main article: 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.
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.
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