Spontaneous Pneumomediastinum and Subcutaneous Emphysema Associated With Diabetic Ketoacidosis: A Case Report

Usman, A; Angelopoulos, J; Kumar, R

Spontaneous Pneumomediastinum and Subcutaneous Emphysema Associated With Diabetic Ketoacidosis: A Case Report

Authors

Usman, A

Angelopoulos, J

Kumar, R

Issue Date

2024

Type

Scientific Paper

Keywords

Research Subject Categories::MEDICINE::Dermatology and venerology,clinical genetics, internal medicine::Internal medicine::Endocrinology

Abstract

Abstract Hamman's syndrome or Macklin phenomenon - spontaneous pneumomediastinum - is an uncommon condition that often gets missed due to the lack of awareness. It may rarely be associated with diabetic ketoacidosis (DKA) due to repeated vomiting or Kussmaul breathing associated with it. This condition is self-resolving, and improvement in symptoms is usually observed with appropriate management of DKA. Secondary pneumomediastinum is relatively more common, but spontaneous pneumomediastinum, which is rare, is often diagnosed incidentally. Here, we describe a case of a 24-year-old gentleman where this condition was found incidentally during the examination and was confirmed through imaging (X-ray and CT scans) and resolved with successful management of DKA. Keywords: diabetic ketoacidosis (dka); emphysema; hamman syndrome; macklin phenomenon; pneumomediastinum. Copyright © 2024, Usman et al. PubMed Disclaimer Conflict of interest statement The authors have declared that no competing interests exist. Figures Figure 1 Figure 1. An anterio-posterior view of chest… Figure 2 Figure 2. Computed tomography scan of the… Figure 3 Figure 3. Sagittal views of computed tomography… Figure 4 Figure 4. Repeat chest X-ray after one… Similar articles Hamman's syndrome in diabetic ketoacidosis. Pain AR, Pomroy J, Benjamin A. Endocrinol Diabetes Metab Case Rep. 2017 Nov 30;2017:17-0135. doi: 10.1530/EDM-17-0135. eCollection 2017. PMID: 29218226 Free PMC article. Hamman's Syndrome Accompanied by Diabetic Ketoacidosis; a Case Report. Yamashita K, Hongo T, Nojima T, Yumoto T, Nakao A, Naito H. Arch Acad Emerg Med. 2022 Aug 21;10(1):e68. doi: 10.22037/aaem.v10i1.1709. eCollection 2022. PMID: 36381967 Free PMC article. Images of the month: An incidental finding of spontaneous pneumomediastinum (Hamman's syndrome) secondary to diabetic ketoacidosis during the coronavirus pandemic. Marchon KA, Nunn MO, Chakera AJ. Clin Med (Lond). 2020 Nov;20(6):e275-e277. doi: 10.7861/clinmed.2020-0739. PMID: 33199339 Free PMC article. Spontaneous pneumomediastinum and Macklin effect: Overview and appearance on computed tomography. Murayama S, Gibo S. World J Radiol. 2014 Nov 28;6(11):850-4. doi: 10.4329/wjr.v6.i11.850. PMID: 25431639 Free PMC article. Review. Spontaneous pneumomediastinum: A comprehensive review of diagnosis and management. Talwar A, Rajeev A, Rachapudi S, Khan S, Singh V, Talwar A. Intractable Rare Dis Res. 2024 Aug 31;13(3):138-147. doi: 10.5582/irdr.2024.01020. PMID: 39220281 Free PMC article. Review. See all similar articles References A case of spontaneous pneumomediastinum and pneumopericardium in a young adult. Lee YJ, Jin SW, Jang SH, et al. Korean J Intern Med. 2001;16:205–209. - PMC - PubMed What causes pneumomediastinum? [ Sep; 2023 ]. 2023. https://www.webmd.com/lung/what-causes-pneumomediastinum https://www.webmd.com/lung/what-causes-pneumomediastinum Pneumomediastinum. [ Oct; 2023 ]. 2023. https://radiopaedia.org/articles/pneumomediastinum?lang=us https://radiopaedia.org/articles/pneumomediastinum?lang=us Pneumomediastinum: old signs and new signs. Bejvan SM, Godwin JD. AJR Am J Roentgenol. 1996;166:1041–1048. - PubMed Spontaneous pneumomediastinum with subcutaneous emphysema in a patient with rheumatoid arthritis and interstitial pneumonia. Nishihata J, Hirai K, Yabe H, Morishita Y. BMJ Case Rep. 2022;15:0. - PMC - PubMed Show all 11 references Publication types Case Reports Related information MedGen LinkOut - more resources Full Text Sources Europe PubMed Central PubMed Central

Citation

Usman A, Angelopoulos J, Kumar R. Spontaneous Pneumomediastinum and Subcutaneous Emphysema Associated With Diabetic Ketoacidosis: A Case Report. Cureus. 2024 May 24;16(5):e61001. doi: 10.7759/cureus.61001. PMID: 38915960; PMCID: PMC11194142.