Spontaneous Pneumomediastinum: A Diagnostic Challenge in a Patient Presenting With Excessive Vomiting and Neck Swelling

Hamman's syndrome, or spontaneous pneumomediastinum, refers to free air in the mediastinum without an apparent cause and typically affects young people. This case report describes a 33-year-old man who presented with neck swelling following excessive vomiting due to alcohol consumption. Clinical examination revealed subcutaneous emphysema of the neck, and imaging confirmed pneumomediastinum. Initial suspicion of Boerhaave syndrome led to aggressive supportive management, but further imaging ruled out oesophageal perforation, confirming Hamman's syndrome. The patient was treated conservatively and discharged after a successful trial of a light diet. This case highlights the diagnostic challenges of Hamman's syndrome, given that its symptoms overlap with more serious conditions like Boerhaave syndrome. Prompt recognition and appropriate conservative management are essential for favourable outcomes, emphasizing the benign and self-limiting nature of Hamman's syndrome.