Hamman's syndrome in a patient with uncontrolled type 1 diabetes mellitus: a case report.

IF 0.8 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2025-05-17 DOI:10.1186/s40981-025-00792-x

Asahi Ishihara, Katsuyuki Sagishima, Tadashi Ejima, Manami Kuwahara, Naoyuki Hirata

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Abstract

Background: 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).

Case presentation: 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.

Conclusion: This case highlights the importance of recognizing Hamman's syndrome in DKA and the need for culturally competent care in international residents.

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1型糖尿病未控制患者的哈曼综合征1例报告。

背景：哈曼综合征是一种以纵隔空气自发渗漏为特征的临床症状。我们报告一例伴有糖尿病酮症酸中毒（DKA）的哈曼综合征患者。病例介绍：一名20岁的外国技术实习生因恶心和呼吸短促到医院就诊。他在他的祖国被诊断出患有糖尿病，并开始胰岛素治疗；然而，自抵达日本以来，他没有获得任何医疗服务。计算机断层扫描显示纵膈气肿，而实验室检查显示明显的高血糖、代谢性酸中毒和血酮水平显著升高（15044µmol/L）。患者被诊断为与DKA相关的哈曼综合征。上消化道内窥镜检查未见胃肠道穿孔。保守的重症监护，包括胰岛素治疗和液体复苏，导致临床改善。结论：本病例强调了在DKA中识别哈曼综合征的重要性，以及在国际居民中进行文化主管护理的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.