Hamman syndrome with a rare feature of pneumorrhachis – an unusual complication of polysubstance abuse and e-vaping
  • Muhammad Saad Anwar
    Department of Internal Medicine, Monmouth Medical Center, Long Branch, USA
  • Anosh Aslam Khan
    Department of Internal Medicine, Monmouth Medical Center, Long Branch, USA
  • Richa Dua
    Department of Internal Medicine, Monmouth Medical Center, Long Branch, USA
  • Fatima Kausar Nawaz
    Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, USA
  • Farhan Khalid
    Department of Internal Medicine, Monmouth Medical Center, Long Branch, USA
  • Doantrang Du
    Department of Internal Medicine, Monmouth Medical Center, Long Branch, USA

Keywords

Pneumorrhachis, hamman syndrome, e-vaping, polysubstance abuse

Abstract

Hamman syndrome is defined as dissection of air in mediastinum and skin fascia usually due to increased intrathoracic pressure. The air leak tends to make its way into pleural and pericardial layers; however, in rare instances air can also dissect into epidural spaces, regarded as pneumorrhachis. We present a case of a young male with a history of polysubstance abuse and e-vaping, who presented with symptoms of altered mental status. Given the concerning physical examination, a computed tomography of the chest was undertaken, which showed pneumothorax, pneumomediastinum and pneumorrhachis. The patient was closely monitored in the intensive care unit and improved after symptomatic management. The symptoms of pneumorrhachis depend on the volume and location of air in intracranial and intraspinal space. Although asymptomatic in our case, it is crucial for clinicians to be aware that pneumorrhachis with Hamman syndrome can potentially cause neurological deficits and cardiopulmonary arrest in severe cases due to increased intraspinal and intracranial hypertension, emphasising the need for close monitoring.

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    Published: 2024-05-02
    Issue: 2024: Vol 11 No 6 (view)


    How to cite:
    1.
    Anwar MS, Khan AA, Dua R, Kausar Nawaz F, Khalid F, Du D. Hamman syndrome with a rare feature of pneumorrhachis – an unusual complication of polysubstance abuse and e-vaping. EJCRIM 2024;11 doi:10.12890/2024_004473.

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