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Case Report
A finding of subcutaneous emphysema: Diagnosing and managing Hamman’s syndrome in a postpartum patient
1 Resident Physician, Department of Obstetrics and Gynecology, Sinai Hospital of Baltimore, Baltimore, Maryland, USA
2 Attending Physician, Department of Maternal Fetal Medicine, Sinai Hospital of Baltimore, Baltimore, Maryland, USA
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Joseph W Bacchi
212 Washington Avenue, Apartment 416, Towson, Maryland 21204,
USA
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Article ID: 100052Z08JB2019
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Bacchi JW, O’Reilly G. A finding of subcutaneous emphysema: Diagnosing and managing Hamman’s syndrome in a postpartum patient. J Case Rep Images Obstet Gynecol 2019;5:100052Z08JB2019.ABSTRACT
Introduction: Hamman’s syndrome, first described by Dr. Louis Hamman in 1945, is a medical condition that results in subcutaneous emphysema secondary to rupture of weakened alveoli. Although it was first described 73 years ago, the disorder is not widely known among obstetricians. This case report discusses the diagnosis and management of Hamman’s syndrome.
Case Report: A 27-year-old, otherwise healthy nulliparous woman presented to the hospital in active labor. She underwent an uncomplicated vaginal delivery. On postpartum day one she presented with crepitus, hoarseness, and facial swelling. Imaging revealed subcutaneous emphysema and pneumopericardium. The patient received a cardiothoracic surgery consult, was ruled out for esophageal rupture, and monitored overnight. Symptoms resolved spontaneously and the patient was followed up as an outpatient.
Conclusion: Clinical manifestations of Hamman’s syndrome can vary widely, making the diagnosis difficult. Providers must be aware of the risk factors and manifestations of the disorder for proper diagnosis and management. Hamman’s syndrome is typically a self-limiting disorder that will resolve spontaneously, however, it is important to rule out severe differential diagnoses.
Keywords: Hamman’s syndrome, Postpartum, Subcutaneous emphysema
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Acknowledgments
A special thank you to the patient for agreeing to participate in this case report as well as the faculty and staff at Sinai Hospital of Baltimore.
Author ContributionsJoseph W Bacchi - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Geralyn O Reilly - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 Joseph W Bacchi et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
