George Daliya, Rajandran Malini, Bhurawala Habib, Leong Gary M
Department of Pediatrics, Nepean Hospital, Penrith, New South Wales, Australia.
Discipline of Pediatrics, The University of Sydney Nepean Medical School, University of Sydney, Sydney, Australia.
Case Rep Pediatr. 2024 Oct 24;2024:1168472. doi: 10.1155/2024/1168472. eCollection 2024.
Hamman's syndrome, a rare complication of diabetic ketoacidosis (DKA), is characterized by subcutaneous emphysema and spontaneous pneumomediastinum. This case report discusses the occurrence of Hamman's syndrome in an 11-year-old adolescent male newly diagnosed with type 1 diabetes mellitus (T1DM) and presenting with severe DKA. The patient exhibited symptoms typical of DKA, including polydipsia, polyuria, abdominal pain, and fatigue, alongside signs such as dehydration, Kussmaul breathing, and tachycardia. Following initial management with intravenous fluids and insulin infusion, he was transferred to a tertiary children's hospital for further care. Subsequently, on routine examination, he exhibited bilateral neck crepitus and a mediastinal crunching sound on auscultation, indicative of Hamman's syndrome. Conservative management led to symptom resolution, and the patient was discharged with follow-up arranged. This case highlights the importance of recognizing Hamman's syndrome as a potential complication of DKA in pediatric patients. Prompt diagnosis and management, along with differentiation from more severe conditions like Boerhaave's syndrome, are crucial for ensuring favorable outcomes. Further awareness and understanding of this rare syndrome are essential for optimal patient care and management.
哈曼综合征是糖尿病酮症酸中毒（DKA）的一种罕见并发症，其特征为皮下气肿和自发性纵隔气肿。本病例报告讨论了一名新诊断为1型糖尿病（T1DM）并伴有严重DKA的11岁青少年男性患者发生哈曼综合征的情况。该患者表现出DKA的典型症状，包括多饮、多尿、腹痛和疲劳，同时伴有脱水、库斯莫尔呼吸和心动过速等体征。在最初通过静脉补液和胰岛素输注进行治疗后，他被转至一家三级儿童医院接受进一步治疗。随后，在常规检查中，他双侧颈部出现捻发音，听诊时可闻及纵隔嘎吱声，提示哈曼综合征。保守治疗使症状得到缓解，患者出院并安排了随访。本病例强调了认识到哈曼综合征是儿科患者DKA潜在并发症的重要性。及时诊断和治疗，以及与诸如博雷尔综合征等更严重疾病相鉴别，对于确保良好预后至关重要。进一步认识和了解这种罕见综合征对于优化患者护理和管理至关重要。
