Hamman’s syndrome with bilateral pneumothoraces in diabetic ketoacidosis: A case report

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BSTRACT

Hamman’s syndrome (spontaneous pneumomediastinum) is a rare but recognized complication of diabetic ketoacidosis (DKA). Concurrent bilateral pneumothorax further complicates management decisions, particularly regarding the need for surgical intervention. We report the case of a 15-year-old boy with newly diagnosed diabetes who presented with DKA complicated by Hamman’s syndrome and bilateral pneumothorax. The patient was successfully managed conservatively with fluid resuscitation, insulin therapy, bed rest, and pain control. His respiratory status normalized by day 3, concurrent with the resolution of acidosis, and he was discharged on day 14. This case demonstrates that conservative management can be successful in DKA-associated Hamman’s syndrome complicated by a small bilateral pneumothoraces when the patient remains hemodynamically stable, thereby avoiding unnecessary invasive procedures.