Spontaneous pneumomediastinum (Hamman's syndrome).

INTRODUCTION Spontaneous pneumomediastinum is defined as the presence of free air in the mediastium in the absence of any obvious precipitating cause. The purpose of this study was to review our experience with this condition, discuss mechanisms and provide a management algorithm. METHODS A retrospective audit of patients admitted with spontaneous pneumomediastinum between 2003 and 2008 was performed. A total of 17 patients were identified. RESULTS Common predisposing factors for spontaneous pneumomediastinum were alcohol excess, asthma and illicit drug use. Vomiting and coughing were common precipitating factors. There was no morbidity, mortality or recurrence. Patients were admitted under a number of different specialties. DISCUSSION Spontaneous pneumomediastinum is a benign self-limiting condition that requires early differentiation from more serious causes, in particular Boerhaave's syndrome.