Hamman’s syndrome (spontaneous pneumomediastinum): about two cases and review of the literature

Pneumomediastinum spontaneous is defined by the presence of air in the mediastinum outside a traumatic, surgical context, and in the absence of underlying pulmonary pathology.
We report the case of two patients who presented spontaneous pneumomediastinum.
CaseN1: 23-year-old, no pathological history, 10th week of the pregnancy, who presents epigastralgia with vomiting and puffiness of the face evolving since 3 days. The clinical examination objectifies an subcutaneous emphysema at the level of the face and of the blow. The biological assessment was normal.  Chest CT scan showed a showed a pneumomediastinum with presence of air in the pulmonary interstitium associated with subcutaneous emphysema extending to the deep spaces of the face. The spontaneous pneumomediastinum syndrome was retained. The management consisted of symptomatic measures with good evolution.
CasN2 : 20-year-old, no pathological history, who comeswith retro-sternal pain, dyspnea, preceded by coughing.The clinical examination found diffuse subcutaneous mph. Biology has been normal. Chest CT scan showed a pneumomédiastinum with pneumothorax. 
The spontaneous pneumomediastinum syndrome was retained. The management consisted of symptomatic measures with good evolution.
Discussion: Spontaneous Pneumomediastinum is a rare entity; it is a diagnosis of elimination that should be retained only after eliminating a rupture of the esophagus which is an extremely urgent life-threateninpatient.