Spontaneous pneumomediastinum (Hamman syndrome)

Case contributed by Dr James Sheldon

Presentation

Day 1 post normal vaginal delivery with thoracic, neck, and facial subcutaneous emphysema.

Patient Data

Age: 25
Gender: Female

Moderate volume pneumomediastinum demonstrated. Normal calibre and opacification of the aortic arch and great vessels. The air encases the oesophogus, trachea and thyroid. It is not possible to exclude an oesphogeal perforation. A trace of gas extends extends into the pleural spaces at the apices and along the fissures of the lungs. A small amount of gas is present at the inferior limit of the imaged descending thoracic aorta/upper abdominal aorta, gas may extend inferior to this region.

Extensive subcutaneous emphysema within the anterior and posterior chest wall extending into the neck (including retropharyngeal), right side of the face and infratemporal fossa. The superior limit of the the subcutaneous gas has not been imaged.

Lungs and pleural spaces are clear with only minor dependant atelectasis on the left of no clinical significance.

No lymphadenopathy. Within the limitations of this study no central pulmonary embolus.

The imaged upper abdomen is normal.

Enostosis right humeral head.

Conclusion

Moderate volume pneumomediastinum. A trace of gas extends extends into the pleural spaces at the apices and along the fissures of the lungs. Extensive subcutaneous emphysema of the chest wall, neck (including retropharyngeal) and face. Both the inferior and superior extent of subcutaneous gas have not been imaged.

Case Discussion

Hamman syndrome is a recognised, but uncommon peri/post partum entity.

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Case information

rID: 41292
Case created: 25th Nov 2015
Last edited: 23rd Sep 2017
Systems: Chest, Obstetrics
Inclusion in quiz mode: Included

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