Hamman's Syndrome - in Young Asthmatic Female

Spontaneous pneumomediastinum (SPM) is a rare condition where there is presence of air in the mediastinum without any precipitating trauma, surgery or other conditions. It usually develops after alveolar rupture and air penetration into the pulmonary interstitium, the hilum and the mediastinum. It is commonly seen in young males, asthmatics on inhalational drugs, or following severe vomiting, parturition, weight lifting. A young female, known case of bronchial asthma presented to us with history of breathlessness and cough of 3 days and mild swelling of the face and neck of 2 days duration. On examination, she was dyspneic, had subcutaneous swelling of the face, neck and chest bilaterally with palpable crepitus. Respiratory examination showed diffuse polyphonic rhonchi and crepitations. CT thorax showed pneumomediastinum, pneumoperitoneum, pneumothorax and pneumorrhachis. A diagnosis of Hamman’s syndrome was made and patient was treated symptomatically and recovered.