A rare complication of diabetic ketoacidosis: spontaneous pneumomediastinum with subcutaneous emphysema

2019 ◽  
Author(s):  
Daniel Yusef ◽  
Henna Khattak ◽  
Leonie Perera ◽  
Saravanakumar Paramalingam ◽  
Shankar Kanumakala
Keyword(s):  
Diabetic Ketoacidosis ◽  
Subcutaneous Emphysema ◽  
Rare Complication ◽  
Spontaneous Pneumomediastinum

scholarly journals Spontaneous pneumomediastinum: rare complication of diabetic ketoacidosis

2009 ◽  
Vol 2009 (mar08 1) ◽  
pp. bcr1020081091-bcr1020081091 ◽  
Author(s):  
W. Banday ◽  
M. Tahir ◽  
S. Jallu ◽  
F. Augustine
Keyword(s):  
Diabetic Ketoacidosis ◽  
Rare Complication ◽  
Spontaneous Pneumomediastinum

scholarly journals Hamman’s syndrome in diabetic ketoacidosis

2017 ◽  
Vol 2017 ◽  
Author(s):  
Alexandra Rose Pain ◽  
Josh Pomroy ◽  
Andrea Benjamin
Keyword(s):  
Differential Diagnosis ◽  
Diabetic Ketoacidosis ◽  
Chest Radiograph ◽  
Subcutaneous Emphysema ◽  
Rare Complication ◽  
Water Soluble ◽  
List Type ◽  
Shortness Of Breath ◽  
Boerhaave’S Syndrome ◽  
Boerhaave's Syndrome

Summary Hamman’s syndrome (spontaneous subcutaneous emphysema and pneumomediastinum) is a rare complication of diabetic ketoacidosis (DKA), with a multifactorial etiology. Awareness of this syndrome is important: it is likely underdiagnosed as the main symptom of shortness of breath is often attributed to Kussmaul’s breathing and the findings on chest radiograph can be subtle and easily missed. It is also important to be aware of and consider Boerhaave’s syndrome as a differential diagnosis, a more serious condition with a 40% mortality rate when diagnosis is delayed. We present a case of pneumomediastinum, pneumopericardium, epidural emphysema and subcutaneous emphysema complicating DKA in an eighteen-year-old patient. We hope that increasing awareness of Hamman’s syndrome, and how to distinguish it from Boerhaave’s syndrome, will lead to better recognition and management of these syndromes in patients with diabetic ketoacidosis. Learning points: Hamman’s syndrome (spontaneous subcutaneous emphysema and pneumomediastinum) is a rare complication of DKA. Presentation may be with chest or neck pain and shortness of breath, and signs are subcutaneous emphysema and Hamman’s sign – a precordial crunching or popping sound during systole. Boerhaave’s syndrome should be considered as a differential diagnosis, especially in cases with severe vomiting. The diagnosis of pneumomediastinum is made on chest radiograph, but a CT thorax with water-soluble oral contrast looking for contrast leak may be required if there is high clinical suspicion of Boerrhave’s syndrome. Hamman’s syndrome has an excellent prognosis, self-resolving with the correction of the ketoacidosis in all published cases in the literature.

scholarly journals A case of spontaneous pneumomediastinum in a patient with severe SARS-CoV-2 and a review of the literature

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110100
Author(s):  
Duong T Hua ◽  
Farah Shah ◽  
Cherlyn Perez-Corral
Keyword(s):  
Subcutaneous Emphysema ◽  
Lung Diseases ◽  
Illicit Drugs ◽  
Positive Pressure Ventilation ◽  
Rare Complication ◽  
Positive Pressure ◽  
Chest Imaging ◽  
Shortness Of Breath ◽  
Spontaneous Pneumomediastinum ◽  
Hypoxic Respiratory Failure

Spontaneous pneumomediastinum is defined as having an etiology that is not related to surgery, trauma, or mechanical ventilation. Precipitating causes of spontaneous pneumomediastinum include coughing, exercise, vomiting, infection, underlying lung diseases such as asthma, and illicit drugs. Symptoms include chest pain, shortness of breath, and dysphagia. A 54-year-old man presented with 2 weeks of shortness of breath, cough, and fever. He was admitted for severe SARS-CoV-2 pneumonia and acute hypoxic respiratory failure requiring non-rebreather mask. Chest imaging on admission showed bilateral peripheral consolidations and pneumomediastinum with subcutaneous emphysema. No precipitating event was identified. He did not require initiation of positive pressure ventilation throughout his admission. On hospital day 7, chest imaging showed resolution of pneumomediastinum and subcutaneous emphysema, and he was successfully discharged on oxygen therapy. Spontaneous pneumomediastinum is a rare complication of severe acute respiratory syndrome coronavirus 2 infection. Spontaneous pneumomediastinum is typically benign and self-limiting, requiring only supportive treatment.

scholarly journals An Unexpected Case of Intrapartum Pneumomediastinum

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Drishti Madhok ◽  
Vinayak Smith ◽  
Erik Gunderson
Keyword(s):  
Nitrous Oxide ◽  
Subcutaneous Emphysema ◽  
Valsalva Maneuver ◽  
Rare Complication ◽  
Healthy Woman ◽  
Second Stage ◽  
Spontaneous Pneumomediastinum ◽  
Second Stage Of Labour

The dyad of spontaneous pneumomediastinum and subcutaneous emphysema is collectively known as Hamman’s syndrome. This rare complication is known to occur during the intrapartum period and its aetiology has been linked to the Valsalva maneuver in the second stage of labour. Nitrous oxide inhalation increases the risk. We present the case of a 21-year-old healthy woman who experienced these symptoms after nitrous oxide inhalation during the second stage of labour.

scholarly journals Spontaneous Pneumomediastinum in Labor

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Mohamed Adnane Berdai ◽  
Said Benlamkadem ◽  
Smael Labib ◽  
Mustapha Harandou
Keyword(s):  
Subcutaneous Emphysema ◽  
Valsalva Maneuver ◽  
Rare Complication ◽  
Diagnostic Technique ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Spontaneous Pneumomediastinum ◽  
Major Interest ◽  
Chest X Ray ◽  
Limiting Condition

Spontaneous pneumomediastinum and subcutaneous emphysema also known as Hamman’s syndrome is a very rare complication of labor that is often related to the valsalva maneuver during the labor. In most case, Hamman’s syndrome is a self-limiting condition, rarely complicated unless there are underlying respiratory diseases. Chest X-ray can be a useful early diagnostic technique in severe clinical presentation. We report an uneventful pregnancy in a primigravid parturient, which was complicated in the late second stage of labor by the development of subcutaneous emphysema, pneumomediastinum, and mild pneumothorax. Spontaneous recovery occurred after four days of conservative management. This condition shows the major interest of labor analgesia especially locoregional techniques.

scholarly journals Pneumomediastinum, pneumopericardium, and subcutaneous emphysema—a rare complication in COVID-19 infection

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Archana Baburao ◽  
Rinki Das ◽  
Shylaja Shyamsunder
Keyword(s):  
Subcutaneous Emphysema ◽  
Early Recognition ◽  
Rare Complication ◽  
Public Health Problem ◽  
Rare Condition ◽  
Prognostic Indicator ◽  
Case Presentation ◽  
Spontaneous Pneumomediastinum ◽  
Global Pandemic ◽  
Almost All

Abstract Background Coronavirus disease 2019 (COVID-19) has become a global pandemic and is posing a serious public health problem for almost all countries. Spontaneous pneumomediastinum, a rare condition, is usually seen in patients with underlying pulmonary pathology, infections, or mechanical ventilation. Spontaneous pneumomediastinum is a rare complication in COVID-19 pneumonia. Case presentation We report a case of spontaneous pneumomediastinum, pneumopericardium, and subcutaneous emphysema in a 62-year-old diabetic patient with COVID-19 infection who presented with cough, fever, and breathlessness, which turned to be a fatal complication. Conclusion Pneumomediastinum/subcutaneous emphysema, a not so common complication associated with COVID-19 infection, should be considered as a bad prognostic indicator of worsening disease and hence requires early recognition and careful monitoring of the patient for any possible unfavorable outcome.

scholarly journals Epidural pneumatosis associated with spontaneous pneumomediastinum: a rare complication of diabetic ketoacidosis

2016 ◽  
pp. bcr2016216295 ◽  
Author(s):  
Mohamed Ahmed ◽  
Mary-Louise Healy ◽  
Donal O'Shea ◽  
Rachel K Crowley
Keyword(s):  
Diabetic Ketoacidosis ◽  
Rare Complication ◽  
Spontaneous Pneumomediastinum

scholarly journals Spontaneous Pneumomediastinum, Pneumothorax, Pneumopericardium and Subcutaneous Emphysema—Not So Uncommon Complications in Patients with COVID-19 Pulmonary Infection—A Series of Cases

2021 ◽  
Vol 10 (7) ◽  
pp. 1346
Author(s):  
Talida Georgiana Cut ◽  
Cristina Tudoran ◽  
Voichita Elena Lazureanu ◽  
Adelina Raluca Marinescu ◽  
Raluca Dumache ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Subcutaneous Emphysema ◽  
Diffuse Alveolar Damage ◽  
Demographic Data ◽  
Pathophysiological Mechanism ◽  
Spontaneous Pneumomediastinum ◽  
Intensive Care Stay ◽  
Laboratory Investigations ◽  
Male Patients ◽  
Pulmonary Pathology

(1) Background: Spontaneous pneumomediastinum (PM), pneumothorax (PT), and pneumopericardium (PP) were recently reported as rare complications in patients with severe COVID-19 pneumonia, and our study aims to follow the evolution of these involvements in 11 cases. The presumed pathophysiological mechanism is air leak due to extensive diffuse alveolar damage followed by alveolar rupture. (2) Methods: We followed the occurrence of PM, PN, PP, and subcutaneous emphysema (SE) in 1648 patients hospitalized during the second outbreak of COVID-19 (October 2020–January 2021) in the main hospital of infectious diseases of our county and recorded their demographic data, laboratory investigations and clinical evolution. (3) Results: Eleven patients (0.66%) developed PM, with eight of them having associated PT, one PP, and seven SE, in the absence of mechanical ventilation. Eight patients (72.72%) died and only three (27.27%) survived. All subjects were nonsmokers, without known pulmonary pathology or risk factors for such complications. (4) Conclusions: pneumomediastinum, pneumothorax, and pneumopericardium are not so uncommon complications of SARS-CoV2 pneumonia, being observed mostly in male patients with severe forms and associated with prolonged hospitalization and poor prognosis. In some cases, with mild forms and reduced pulmonary injury, the outcome is favorable, not requiring surgical procedures, mechanical ventilation, or intensive care stay.

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