scholarly journals Hamman’s syndrome: spontaneous pneumomediastinum and subcutaneous emphysema during second stage of labour

2017 ◽  
Vol 6 (6) ◽  
pp. 2622
Author(s):  
Ying Yiing Lou
Keyword(s):  
Subcutaneous Emphysema ◽  
Early Recognition ◽  
Rare Complication ◽  
Anterior Chest Wall ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Chest X Ray ◽  
Surgical Emphysema ◽  
Future Pregnancy ◽  
Limiting Condition

Subcutaneous emphysema with pneumomediastinum in labour is also known as Hamman's Syndrome. Maternal pneumomediastinum associated with subcutaneous emphysema is a rare complication of pregnancy. The incidence rate being between 1:2000 and 1:10,000. Pneumomediastinum occurs most frequently in the second stage of labour in a healthy primiparous women with prolonged labour. A 29-year-old primigravida, who had no relevant medical history, had an uneventful spontaneous vaginal delivery at term. She used Entonox as analgesia in labour. She developed facial and neck oedema associated with mild breathing discomfort towards the end of her second stage. Crepitus was felt in her cheek, neck and anterior chest wall. Observations were stable including oxygen saturation. Chest X-ray demonstrated gross and extensive surgical emphysema across the chest and up into the neck and with no evidence of pneumothorax. She was managed conservatively and the subcutaneous emphysema was found to have considerably better within 24 hours. She recovered uneventfully and was discharged within 3 days of admission. A future pregnancy is planned. Hamman’s syndrome is generally a self-limiting condition. The key to successful management is early recognition followed by appropriate measures to prevent further complications in order to reduce the morbidity and mortality associated with this condition. Supportive measures alone may be the only requirement for resolution. Recurrence of the condition is rare but the appropriate management of subsequent pregnancies is unclear. Our case was appropriately managed with multidisciplinary input in the HDU on labour ward.

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.

Cardiac instability due to Pneumomediastinum during second stage of labour

2009 ◽  
Vol 54 (2) ◽  
pp. 58-58
Author(s):  
J Rafi ◽  
H Muppala ◽  
B Schaefer
Keyword(s):  
Subcutaneous Emphysema ◽  
Case Reports ◽  
Neck Region ◽  
High Dependency Unit ◽  
X Ray ◽  
Second Stage ◽  
Cardiovascular Instability ◽  
Second Stage Of Labour ◽  
High Dependency ◽  
Chest X Ray

This case reports spontaneous pneumomediastinum in the second stage of labour leading to cardiovascular instability. Forceps were used to expedite delivery. Examination revealed characteristic crepitus of subcutaneous emphysema in the neck region, which was confirmed on chest X-Ray and CT scan. The patient was managed in the high dependency unit (HDU) for 48 hours and made a full recovery.

scholarly journals Case report: Postpartum pneumomediastinum and subcutaneous emphysema

2018 ◽  
Vol 12 (3) ◽  
pp. 143-145
Author(s):  
AD Jakes ◽  
K Kunde ◽  
A Banerjee
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Subcutaneous Emphysema ◽  
Oxygen Therapy ◽  
Rare Complication ◽  
Supplemental Oxygen ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Nasal Flow ◽  
Repeat Imaging

Postpartum pneumomediastinum is a rare complication of labour and delivery, where air leaks into the mediastinum following rupture of marginal alveoli. It follows prolonged and forceful Valsalva manoeuvres that increase intra-thoracic pressure. Subcutaneous emphysema may also develop. A chest radiograph can confirm the diagnosis, however a computed tomography thorax maybe required. Treatment is conservative as it is usually self-limiting. We present a case of postpartum pneumomediastinum following a delay in the second stage of labour and subsequent instrumental delivery. She developed chest pain and dyspnea 40 min post-delivery, and subcutaneous emphysema was palpable. Supplementary nasal flow oxygen was administered for 24 h prior to discharge. There is sparse evidence or guidance as to the management of postpartum pneumomediastinum, but consensus appears to be supplemental oxygen for 24 h. More data are needed on the type and duration of oxygen therapy, need for repeat imaging and management of subsequent pregnancies.

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 Hamman’s syndrome: a case report of spontaneous pneumomediastinum after vaginal delivery

2020 ◽  
Vol 9 (4) ◽  
pp. 1735
Author(s):  
Marco Gentile ◽  
Mariaconcetta Zinna ◽  
Antonio Costanza ◽  
Andrea Remo ◽  
Giuseppe Sala ◽  
...  
Keyword(s):  
Rare Complication ◽  
Rare Condition ◽  
Medical Problem ◽  
Lateral View ◽  
X Ray ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Spontaneous Pneumomediastinum ◽  
Second Stage Of Labour ◽  
Chest X Ray

Spontaneous pneumediastinum (Hamman’s syndrome) is a rare pathology defined as the presence of free air in the mediastinum with subcutaneous emphysema without trauma or medical problem. It is also a rare complication of labour and delivery and it usually occurs in the second stage of labour. A twenty-six-year-old primigravida presented to our hospital at 39 weeks and 6 days in spontaneous labour. Two hours following the delivery the patient developed neck tightness and chest tenderness with palpation. Chest X-ray and CT scan revealed pneumomediastinum extending into the soft tissue of the neck. A conservative management was performed. Spontaneous pneumomediastinum is a rare condition with a reported incidence of less than 1:44000 and in the setting of pregnancy or labor 1:100000. Regarding pregnancy, the valsalva maneuvers produced in the second stage of labor has been implicated in the development of spontaneous pneumomediastinum. Chest X-ray (posteroanterior and lateral view) is the most important test to confirm the diagnosis. The Hamman’s syndrome has usually a benign course and the management in often conservative. A timely diagnosis of Hamman’s syndrome is necessary for patient safety and correct management, but most cases have a self-limiting course.

scholarly journals Spontaneous pneumomediastinum and subcutaneous emphysema in a child with unknown aetiology

2019 ◽  
Vol 12 (2) ◽  
pp. e226805
Author(s):  
Anoopkishore Chidambaram ◽  
Sirisha Donekal
Keyword(s):  
Subcutaneous Emphysema ◽  
Rare Entity ◽  
X Ray ◽  
Spontaneous Pneumomediastinum ◽  
Expert Opinions ◽  
Repeat Chest ◽  
Chest X Ray ◽  
Red Flag ◽  
Surgical Emphysema ◽  
Safety Netting

Spontaneous subcutaneous emphysema and pneumomediastinum in children without any predisposing factors is a rare entity. We present a case of an adolescent boy with spontaneous pneumomediastinum. He is a 14-year-old boy brought to the hospital with an odd feeling in the neck and chest. Initial chest X-ray revealed subcutaneous emphysema and pneumomediastinum. He was further evaluated with CT thorax and abdomen with contrast which revealed extensive pneumomediastinum with associated surgical emphysema in the chest wall and neck. Expert opinions from the cardiothoracic and respiratory teams were obtained. The child was discharged with safety netting and description of red flag signs. Repeat chest X-ray in 2 weeks showed complete resolution of the pneumomediastinum and subcutaneous emphysema. We will briefly discuss about the diagnosis and treatment of spontaneous pneumomediastinum and subcutaneous emphysema.

scholarly journals Pneumomediastinum, Pneumopericardium, and Epidural Pneumatosis following Adenotonsillectomy: A Very Rare Complication

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Feride Fatma Görgülü ◽  
Ayşe Selcan Koç ◽  
Orhan Görgülü
Keyword(s):  
Carotid Artery ◽  
Subcutaneous Emphysema ◽  
Early Recognition ◽  
Rare Complication ◽  
Rare Condition ◽  
Male Child ◽  
Radiological Findings ◽  
Unique Case ◽  
Unusual Condition ◽  
Taste Disorders

Adenotonsillectomy is a common surgical otolaryngology procedure that is associated with several complications, including hemorrhage, odynophagia, damage to teeth, taste disorders, atlantoaxial subluxation, lingual edema, infection, and injury of the carotid artery. Pneumomediastinum, pneumopericardium, and epidural pneumatosis are an extremely unusual condition in children with adenotonsillectomy. Treatment should be conservative in the majority of cases and based on benign self-limiting course of these diseases; early recognition can prevent further complications. The combination of pneumomediastinum with epidural pneumatosis, pneumopericardium, retropharyngeal-prevertebral pneumatosis, axillar-perihumeral pneumatosis, and subcutaneous emphysema is also a very rare condition. We present a unique case with the radiological findings of air in all of these areas in a 6-year-old male child with adenotonsillectomy. The case was unusual in that the patient developed this complication 3 hours later after adenotonsillectomy with severe vomitting. The possible mechanism, the algorithm of treatment, and precautions in such cases will be discussed.

Spontaneous pneumomediastinum: A report of two cases at a District General Hospital

2021 ◽  
pp. 1753495X2110192
Author(s):  
Nathanael Yong ◽  
Oladimeji Olowu
Keyword(s):  
Chest Pain ◽  
Rare Condition ◽  
District General Hospital ◽  
Valsalva Manoeuvre ◽  
Second Stage ◽  
Spontaneous Pneumomediastinum ◽  
Management Algorithm ◽  
Second Stage Of Labour ◽  
Management Approaches ◽  
Limiting Condition

Spontaneous pneumomediastinum is a rare condition thought to be caused by excessive Valsalva manoeuvre during the second stage of labour. Women with pneumomediastinum typically presents with chest pain or tightness, dyspnoea, and a tearing sensation around the neck. It is commonly diagnosed with a chest radiograph but further imaging may be necessary to exclude more sinister conditions with similar clinical features. We describe two cases of pneumomediastinum and the different management approaches with different multi-disciplinary input. It is often a self-limiting condition. We propose a management algorithm for women suspected to have pneumomediastinum during the intrapartum and postpartum period.

scholarly journals Subcutaneous emphysema and hypercarbia as a complication of laparoscopic procedure: case report

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Sadal K Aldakhil ◽  
Abeer A Tashkandi ◽  
Mohammed K Al Harbi ◽  
Adel Al Shehri
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Subcutaneous Emphysema ◽  
Rare Complication ◽  
Respiratory Acidosis ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Laparoscopic Procedure ◽  
Surgical Emphysema ◽  
Low Incidence ◽  
Associated Risk Factors

Abstract Subcutaneous emphysema (SE) is a rare complication of laparoscopic procedures, with an incidence rate of only 0.43–2.3%. In this report, we present a case of a 28-year-old male who underwent an elective laparoscopic inguinal hernia repair and developed surgical emphysema, hypercarbia and respiratory acidosis intraoperatively. Based on our findings, we concluded that regardless of the low incidence of SE, awareness of the associated risk factors should be ensured to avoid laparoscopic procedure-related complications.

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.

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