Hamman syndrome

Case contributed by Dr Stan Buckens

Presentation

Swelling of the face, directly after childbirth at home.

Patient Data

Age: 30 years
Gender: Female

Chest

CT

The chest CT shows pneumomediastinum, pneumothorax and subcutaneous emphysema (air everywhere).  

Case Discussion

The patient presented with postpartum swelling of the face, directly after childbirth at home. Initially, the attending midwife suspected an anaphylactic reaction to the administered oxytocin and referred her to the obstetrics department. They established that the swelling was caused by subcutaneous emphysema and ordered a chest CT. The chest CT shows pneumomediastinum, pneumothorax and subcutaneous emphysema.  

This is an example of spontaneous pneumomediastinum and subcutaneous emphysema, in this case after childbirth, also known as Hamman syndrome or as Macklin syndrome. Childbirth typically involves physical exertion and it has been posited that this can cause a rupture of alveolar membranes, causing a positive pressure gradient from the lungs to the surrounding tissues. The course is usually self-limiting. This patient recuperated at home without complications.

I acknowledge MJA Gondrie, the reading radiologist, for kindly allowing me to submit this case. 

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