PDF(Pubmed)
Abstract：
Hamman\'s syndrome is a rare condition that mostly affects young males, often with a predisposition to asthma. It includes the presence of free air in the mediastinum and subcutaneous emphysema with no other underlying cause such as trauma, infection, or administration of any sort of mask support with hyperpressure. It occurs spontaneously and often in association with a prolonged Valsalva maneuver. This might explain why there are some cases of Hamman\'s syndrome among young females giving birth. Here, we present a case report of a 24-year-old non-smoker primigravida with Hamman\'s syndrome. She presented with symptoms a few hours after an uncomplicated vaginal delivery at 40 + 1 weeks of pregnancy where the active phase of labor lasted for three hours with normal progress. The second stage lasted for 30 min, with no signs of distress on CTG. The symptoms (pain in the right ear, swelling and pain in the neck, chest tightness, shortness of breath, dysphagia, odynophagia, and pain in the upper thorax on the right side) and objective findings as subcutaneous crepitations in the neck, parasternal region, right axillary fossa, clavicle and over the chest resolved spontaneously after a few days of observation and conservative management. We also give a systemic review of reported cases since 2000 to provide an overview of the pathomechanism, symptoms, diagnostics, treatment, and management of this condition. Hamman\'s syndrome is a rare, usually benign, but potentially serious complication that can occur during the second stage of labor. Diagnostics include inquiring about typical symptoms, clinical examination, and chest x-ray or CT scan. Treatment is usually conservative with oxygen, bronchodilators, and pain relief. The recurrence rate is low and there is no contraindication to vaginal delivery in future pregnancies. However, it is suggested that physicians and midwives be cautious and consider a low threshold for instrumental delivery or cesarean section to avoid excessive Valsalva maneuvers.
摘要：
哈曼综合征是一种罕见的疾病，主要影响年轻男性，经常有哮喘的倾向。它包括纵隔和皮下气肿中游离空气的存在，没有其他潜在原因，如创伤，感染,或使用任何类型的面罩支持超压。它是自发发生的，通常与长时间的Valsalva动作有关。这也许可以解释为什么在分娩的年轻女性中会出现一些哈曼综合征的情况。这里,我们介绍一例24岁非吸烟者伴Hamman综合征的初治患者。在怀孕40+1周时，她在无并发症的阴道分娩后数小时出现症状，分娩的活动期持续了三个小时，进展正常。第二阶段持续30分钟，CTG上没有任何不适的迹象.症状（右耳疼痛，颈部肿胀和疼痛，胸闷,呼吸急促,吞咽困难,吞咽困难,和右侧上胸部疼痛）和颈部皮下蠕动的客观发现，胸骨旁区域,右腋窝,经过几天的观察和保守治疗，锁骨和胸部可自行消退。我们还对自2000年以来报告的病例进行了系统回顾，以提供病理机制的概述。症状,诊断,治疗,和管理这种情况。哈曼综合征是一种罕见的,通常是良性的，但可能在第二产程发生的严重并发症。诊断包括询问典型症状，临床检查,和胸部X光或CT扫描。治疗通常是保守的氧气，支气管扩张剂,和疼痛缓解。复发率低，未来妊娠阴道分娩没有禁忌症。然而,建议医师和助产士谨慎,并考虑低门槛的器械分娩或剖宫产,以避免过度的Valsalva操作.
