Hamman syndrome

Case contributed by Mohamed Adel Sherif


4-day history of fever and violent cough, presented with neck swelling and crepitus.

Patient Data

Age: 2 years
Gender: Male

Initial chest x-ray


Pneumomediastinum and extensive neck subcutaneous emphysema.

Left middle zone consolidation.

CECT Chest with oral and IV


Left lingular consolidation with air bronchogram, in keeping with pneumonia.

Left upper lobe interstitial emphysema tracking to the hilum with pneumomediastinum and extensive subcutaneous emphysema involving the neck and upper chest wall, associated with cervical intraspinal extradural air (pneumorrhachis) and pneumoperitoneum locules.

Follow up chest x-ray


Follow-up chest x-ray after 2 days shows interval improvement of the subcutaneous emphysema and pneumomediastinum, as well as clearing of the left upper lobe infiltrate.

Case Discussion

Rare pediatric case of Hamman syndrome, i.e. spontaneous pneumomediastinum and subcutaneous emphysema.

The patient presented with with a severe cough due to pneumonia, leading to spontaneous pulmonary interstitial emphysema via alveolar rupture. Air tracking to the hilum resulted in pneumomediastinum and extensive subcutaneous emphysema of the neck and upper chest wall, associated with pneumorrhachis and pneumoperitoneum.

Perforation and foreign body aspiration were ruled out.

The case was managed conservatively, with interval improvement on the follow-up x-rays. 

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