Spontaneous pneumomediastinum (Hamman syndrome)
Swelling of the face, directly after childbirth at home.
Chest CT: Hamman´s syndrome
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The chest CT shows pneumomediastinum, pneumothorax and subcutaneous emphysema (air everywhere).
30 year old causasian female presenting with post partum swelling of the face, directly after childbirth at home. Initially the attending midwife suspected an anaphylactic reaction to the adminstered oxytocin and referred her to the obstetrics department. They established that the swelling was caused by subcutaneous emphysema and ordered a chest CT.
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.