Hamman Syndrome in Diabetic Ketoacidosis: Unveiling a Rare and Life-Threatening Complication

Hamman syndrome, or spontaneous pneumomediastinum, is a rare condition characterized by the presence of free air in the mediastinum, often triggered by increased intrathoracic pressure from vomiting, coughing, or intense physical exertion. Its association with diabetic ketoacidosis (DKA) is extremely uncommon. We report a case of an 18-year-old male with poorly controlled type 1 diabetes who developed DKA complicated by pneumomediastinum, subcutaneous emphysema, and a small pneumothorax. The condition was likely precipitated by Kussmaul's respiration and severe vomiting. After treatment for DKA with insulin and fluids, the patient improved, and follow-up imaging showed complete resolution of the pneumomediastinum. This case underscores the importance of recognizing and managing this rare complication in patients with DKA.