Ishihara Asahi, Sagishima Katsuyuki, Ejima Tadashi, Kuwahara Manami, Hirata Naoyuki
Department of Critical Care Medicine, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan.
Department of Anesthesiology, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan.
JA Clin Rep. 2025 May 17;11(1):28. doi: 10.1186/s40981-025-00792-x.
Hamman's syndrome is a clinical entity characterized by the spontaneous leakage of air into the mediastinum. We report a patient with Hamman's syndrome associated with diabetes ketoacidosis (DKA).
A 20-year-old foreign technical intern visited to a hospital because of nausea and shortness of breath. He had been diagnosed with diabetes in his home country and had initiated insulin therapy; however, since arriving in Japan, he had not accessed any medical services. Computed tomography revealed pneumomediastinum, while laboratory tests showed marked hyperglycemia, metabolic acidosis, and a significantly elevated blood ketone level (15,044 µmol/L). The patient was diagnosed with Hamman's syndrome associated with DKA. Upper gastrointestinal endoscopy showed no evidence of gastrointestinal perforation. Conservative intensive care, including insulin therapy and fluid resuscitation, resulted in clinical improvement.
This case highlights the importance of recognizing Hamman's syndrome in DKA and the need for culturally competent care in international residents.
Hamman综合征是一种以空气自发漏入纵隔为特征的临床病症。我们报告一例与糖尿病酮症酸中毒（DKA）相关的Hamman综合征患者。
一名20岁的外国技术实习生因恶心和呼吸急促到医院就诊。他在本国被诊断患有糖尿病并开始胰岛素治疗；然而，自抵达日本以来，他未接受任何医疗服务。计算机断层扫描显示纵隔气肿，而实验室检查显示明显的高血糖、代谢性酸中毒以及血酮水平显著升高（15,044微摩尔/升）。该患者被诊断为与DKA相关的Hamman综合征。上消化道内镜检查未发现胃肠道穿孔的证据。包括胰岛素治疗和液体复苏在内的保守重症监护使病情得到临床改善。
本病例强调了在DKA中认识Hamman综合征的重要性以及对国际居民进行具有文化胜任力护理的必要性。
