Hamman syndrome
Hamman syndrome, also known as Macklin syndrome, refers to spontaneous pneumomediastinum along with subcutaneous emphysema.
Epidemiology
It is a rare entity most often encountered in young adults. It is a known entity peri- and postpartum .
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 .
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 .