Spontaneous pneumomediastinum (Hamman’s syndrome): presenting as acute severe asthma

Spontaneous pneumomediastinum (SPM) is an uncommon finding and clinicians must consider this during their clinical evaluation. High degree of suspicion and appropriate investigations play key roles in early diagnosis and avoiding potential life-threatening complications. SPM usually presents without any comorbidities (primary) or due to an underlying pathology (secondary), such as underlying asthma, barotrauma, valsalva manoeuvre or an oesophageal rupture. Patients can have varying clinical symptoms; the majority will have subcutaneous emphysema and Hamman’s sign (mediastinal crunching sound on auscultation). The prognosis of SPM is usually good with resolution in most cases, and it has a low recurrence rate. We report a case of SPM in a young 19-year-old male who presented with symptoms of acute severe asthma and who made a complete resolution with conservative management.