Hamman’s syndrome: a rare cause of thoracic pain in children
DOI:
https://doi.org/10.21615/cesmedicina.35.1.7Keywords:
Mediastinal emphysema, Chest pain, Diagnosis, Hamman Syndrome , Subcutaneous enphysema , ChildrenAbstract
Introduction: chest pain is a frequent cause of consultation to the pediatric emergency department. A little-known cause is pneumomediastinum, which can be classified as secondary, when there is a trigger and spontaneous, when there is no evident cause. It is also called Hamman's syndrome, which has an incidence ranging from one in 30 000 to 44 000 emergency department visits and occurs predominantly in males.
Report: We present the case of a 12-year-old girl, previously healthy, who consulted for 12 hours of chest pain with pleuritic characteristics of sudden onset, associated with dyspnea and diaphoresis, with no history of trauma, respiratory or gastrointestinal symptoms or other previous symptomatology. The patient was subsequently diagnosed with spontaneous pneumomediastinum.
Discussion: this disease is very rare in children. Most cases are rapidly self-limited with symptomatic management and very few can be complicated with cardiac tamponade. Chest radiography is the most accurate diagnostic method.
Downloads
References
Selbst S. Approach to the child with chest pain. Pediatr Clin N Am. 2010; 57:1221-34. https://doi.org/10.1016/j.pcl.2010.09.003
Massin MM, Bourguignont A, Coremans C, Comté L, Lepage P, et al. Chest pain in pediatric patents presenting to an emergency department or to a cardiac clinic. Clin Pediatr. 2004; 43(3): 231–8. DOI: 10.1177/000992280404300304
Sert A, Aypar E, Odabas D, Gokcen C. Clinical characteristics and causes of chest pain in 380 children referred to a paediatric cardiology unit. Cardiology in the Young. 2013; 23(3): 361–67. https://doi.org/10.1017/S1047951112000881
Thull-Freedman J. Evaluation of chest pain in the pediatric patient. The Medical clinics of North America. 2010; 94(2): 327–47. https://doi.org/10.1016/j.mcna.2010.01.00
Kouritas VK, Papagiannopoulos K, Lazaridis G, Baka S, Mpoukovinas I, Karavasilis V, et al. Pneumomediastinum. J Thorac Dis. 2015; 7(1): S44–S49. http://dx.doi.org/10.3978/j.issn.2072-1439.2015.01.11
Campbell S, Vargas SA, Gómez JM, Escobar AE, Muñoz JK. Hamman Syndrome. Acta Med Colomb. 2016; 41(3): 206-10. https://doi.org/10.36104/amc.2016.710
Morcillo KL, Vallejo EL. Síndrome de Hamman: presentación de dolor torácico en un adolescente. Rev Colomb Cardiol. 2015;22(1):62-65. https://doi.org/10.1016/j.rccar.2014.12.002
Ryoo JY. Clinical analysis of spontaneous pneumomediastinum. Tuberc Respir Dis. 2012; 73(3): 169-73. https://dx.doi.org/10.4046 %2Ftrd.2012.73.3.169
Johnson NN, Toledo A, Endom EE. Pneumothorax, pneumomediastinum, and pulmonary embolism. Pediatr Clin N Am. 2010; 57(6): 1357-83. https://doi.org/10.1016/j.pcl.2010.09.009
Gerazounis M, Athanassiadi K, Kalantzi N, Moustardas M. Spontaneous pneumomediastinum: a rare benign entity. The Journal of thoracic and cardiovascular surgery. 2003. 126(3): 774–76. https://doi.org/10.1016/s0022-5223(03)00124-7
Bakhos C, Pupovac S, Ata A, Fantauzzi J, Fabian T. Spontaneous pneumomediastinum: an extensive workup is not required. Journal of the American College of Surgeons. 2014. 219 (4): 713–17. https://doi.org/10.1016/j.jamcollsurg.2014.06.001
Pauw R, Van der Werf TS, Van Dullemen HM, Dullaart R. Mediastinal emphysema complicating diabetic ketoacidosis: plea for conservative diagnostic approach. The Netherlands journal of medicine. 2007. 65(10): 368–71.
Van Veelen I, Hogeman PH, Van Elburg A, Nielsen-Abbring FW, Heggelman BG, et al. Pneumomediastinum: a rare complication of anorexia nervosa in children and adolescents. A case study and review of the literature. Eur J Pediatr. 2007. 167(2): 171-74. DOI: 10.1007/s00431-007-0444-9
Ovalle P, Arce J. Neumomediastino espontáneo: enfisema retrofaríngeo forma de presentación no habitual. Rev Chil Radiol. 2005; 11(3): 116-21.
Mohamed W, Exley C, Sutcliffe I, Dwarakanath A. Spontaneous pneumomediastinum (Hamman's syndrome): presenting as acute severe asthma. J R Coll Physicians Edinb. 2019; 49(1): 31–33. https://doi.org/10.4997/JRCPE.2019.106
Chalumeau M, Le Clainche L, Sayeg N, Sannier N, Michel J, et al. Spontaneous pneumomediastinum in children. Pediatric pulmonology. 2001; 31(1): 67–75. https://doi.org/10.1002/1099-0496(200101)31:1<67::aid-ppul1009>3.0.co;2-j
Perna V, Vila E, Guelbenzu JJ, Amat I. Pneumomediastinum: is this really a benign entity? When it can be considered as spontaneous? Our experience in 47 adult patients. Eur. J. Cardio. 2010; 37(3): 573–575. http://dx.doi.org/10.1016/j.ejcts.2009.08.002
Kelly S, Hughes S, Nixon S, Paterson-Brown S. Spontaneous pneumomediastinum (Hamman’s syndrome). Surgeon. 2010;8(2):63-6. https://doi.org/10.1016/j.surge.2009.10.007
Chidambaram A, Donekal S. Spontaneous pneumomediastinum and subcutaneous emphysema in a child with unknown aetiology. BMJ Case Rep. 2019;12(2): 226-29. https://doi.org/10.1136/bcr-2018-226805
Alishlash SA, Janahi IA. Spontaneous pneumomediastinum in children and adolescents. [Sitio en Internet] UpToDate. Hallado en URL: https://www.uptodate.com/contents/spontaneous-pneumomediastinum-in-children-and-adolescents. Acceso en agosto de 2019.
Kim SH, Huh J, Song J, Kang IS. Spontaneous pneumomediastinum: a rare disease associated with chest pain in adolescents. Yonsei Med J. 2015;56(5):1437–42. http://dx.doi.org/10.3349/ymj.2015.56.5.1437
Benlamkaddem S, Berdai MA, Labib S, Harandou M. A case of spontaneous pneumomediastinum with subcutaneous emphysema in children. Children. 2018;5(2):22. https://doi.org/10.3390/children5020022
Anantasit N, Manuyakorn W, Anantasit N, Choong K, Preuthipan A. spontaneous pneumomediastinum in non-asthmatic children with exercise-induced bronchoconstriction. Am J Case Rep. 2015;16:648–51. https://doi.org/10.12659/ajcr.894884
Abbas PI, Akinkuotu AC, Peterson ML, Mazziotti MV. Spontaneous pneumomediastinum in the pediatric patient. Am J Surg. 2015;210(6):1031–6. https://doi.org/10.1016/j.amjsurg.2015.08.002
Fernández A, Silvariño R, Carissi JM, Otero E, Zubiaurre J, Méndez E. Spontaneous pneumomediastinum: clinical case and literature review. Arch Med Interna. 2012; 34(2): 57-59.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 CES Medicina
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Derechos de reproducción (copyright)
Cada manuscrito se acompañará de una declaración en la que se especifique que los materiales son inéditos, que no han sido publicados anteriormente en formato impreso o electrónico y que no se presentarán a ningún otro medio antes de conocer la decisión de la revista. En todo caso, cualquier publicación anterior, sea en forma impresa o electrónica, deberá darse a conocer a la redacción por escrito.
Plagios, duplicaciones totales o parciales, traduccones del original a otro idioma son de responsabilidad exclusiva de los autores el envío.
Los autores adjuntarán una declaración firmada indicando que, si el manuscrito se acepta para su publicación, los derechos de reproducción son propiedad exclusiva de la Revista CES Medicina.
Se solicita a los autores que proporcionen la información completa acerca de cualquier beca o subvención recibida de una entidad comercial u otro grupo con intereses privados, u otro organismo, para costear parcial o totalmente el trabajo en que se basa el artículo.
Los autores tienen la responsabilidad de obtener los permisos necesarios para reproducir cualquier material protegido por derechos de reproducción. El manuscrito se acompañará de la carta original que otorgue ese permiso y en ella debe especificarse con exactitud el número del cuadro o figura o el texto exacto que se citará y cómo se usará, así como la referencia bibliográfica completa.
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
