An unusual cause of shortness of breath: hamman syndrome.

A 41-year-old primiparous low-risk woman developed dyspnea and generalized head and neck swelling after a normal delivery of a healthy neonate. A chest x-ray demonstrated surgical emphysema in the neck and a suggestion of pneumomediastinum (arrows, Figure panel A). A computed tomography examination with oral contrast demonstrated surgical emphysema and air in the anterior, middle, and posterior mediastinum (arrows, Figure panels B-D). No pneumothorax or esophageal perforation was identified. A diagnosis of Hamman syndrome was made. This condition, originally described by Louis Virgil Hamman, is the classic association of subcutaneous emphysema, pneumomediastinum, with or without pneumothorax [Hamman 1939]. It is associated with prolonged valsalva [Kostiainen 1975]. This unusual condition must be considered as a differential diagnosis. These patients have a good outcome with conservative management, as in this case. This patient’s condition resolved spontaneously in 48 hours.