{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:43:09Z","timestamp":1787020989078,"version":"build-2736575974"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T00:00:00Z","timestamp":1747440000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T00:00:00Z","timestamp":1747440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hamman\u2019s syndrome is a clinical entity characterized by the spontaneous leakage of air into the mediastinum. We report a patient with Hamman\u2019s syndrome associated with diabetes ketoacidosis (DKA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 20-year-old foreign technical intern visited to a hospital because of nausea and shortness of breath. He had been diagnosed with diabetes in his home country and had initiated insulin therapy; however, since arriving in Japan, he had not accessed any medical services. Computed tomography revealed pneumomediastinum, while laboratory tests showed marked hyperglycemia, metabolic acidosis, and a significantly elevated blood ketone level (15,044\u00a0\u00b5mol\/L). The patient was diagnosed with Hamman\u2019s syndrome associated with DKA. Upper gastrointestinal endoscopy showed no evidence of gastrointestinal perforation. Conservative intensive care, including insulin therapy and fluid resuscitation, resulted in clinical improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights the importance of recognizing Hamman\u2019s syndrome in DKA and the need for culturally competent care in international residents.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40981-025-00792-x","type":"journal-article","created":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T08:58:08Z","timestamp":1747472288000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hamman\u2019s syndrome in a patient with uncontrolled type 1 diabetes mellitus: a case report"],"prefix":"10.1186","volume":"11","author":[{"given":"Asahi","family":"Ishihara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuyuki","family":"Sagishima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Ejima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manami","family":"Kuwahara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3776-8115","authenticated-orcid":false,"given":"Naoyuki","family":"Hirata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,17]]},"reference":[{"key":"792_CR1","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1016\/0002-9610(76)90008-8","volume":"131","author":"DJ McMahon","year":"1968","unstructured":"McMahon DJ. Spontaneous pneumomediastinum. Am J Surg. 1968;131:550\u20131.","journal-title":"Am J Surg"},{"key":"792_CR2","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.surge.2009.10.007","volume":"8","author":"S Kelly","year":"2010","unstructured":"Kelly S, Hughes S, Nixon S, Paterson-Brown S. Spontaneous pneumomediastinum (Hamman\u2019s syndrome). Surgeon. 2010;8:63\u20136.","journal-title":"Surgeon"},{"key":"792_CR3","first-page":"537","volume":"37","author":"V Perna","year":"2010","unstructured":"Perna V, Vil\u00e0 E, Guelbenzu JJ, Amat I. Pneumomediastinum: Is this really a benign entity? When it can be considered as spontaneous? Our experience in 47 adult patients. Eur J Cardiothrac Surg. 2010;37:537\u201345.","journal-title":"Eur J Cardiothrac Surg"},{"key":"792_CR4","doi-asserted-by":"publisher","first-page":"znae216","DOI":"10.1093\/bjs\/znae216","volume":"111","author":"T Hauge","year":"2024","unstructured":"Hauge T, Abu Hejleh A, Nilsson M, Schr\u00f6der W. Boerhaave syndrome. Br J Surg. 2024;111:znae216.","journal-title":"Br J Surg"},{"key":"792_CR5","doi-asserted-by":"publisher","first-page":"105691","DOI":"10.1016\/j.ijscr.2021.105691","volume":"80","author":"H Hayashi","year":"2021","unstructured":"Hayashi H, Nagao N, Yamazaki K, Asai R, Tanaka C, Kawai M. Spontaneous esophageal rupture managed with endoscopic closure using an over-the-scope clip: A case report. Int J Surg Rep. 2021;80:105691.","journal-title":"Int J Surg Rep"},{"key":"792_CR6","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1016\/S1056-8727(03)00059-X","volume":"18","author":"P Pooyan","year":"2004","unstructured":"Pooyan P, Puruckherr M, Summers JA, Byrd RP Jr, Roy TM. Pneumomediastinum, pneumopericardium, and epidural pneumotosis in DKA. J Diabetes Complications. 2004;18:242\u20137.","journal-title":"J Diabetes Complications"},{"key":"792_CR7","first-page":"17","volume":"2017","author":"AR Pain","year":"2017","unstructured":"Pain AR, Pomroy J, Benjamin A. Hamman\u2019s syndrome in diabetic ketoacidosis. Endocrinol Diabetes Metab Case Rep. 2017;2017:17\u20130135.","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"792_CR8","first-page":"368","volume":"10","author":"K Yamashita","year":"2022","unstructured":"Yamashita K, Hongo T, Nojima T, Yumoto T, Nakao A, Naito H. Hamman\u2019s syndrome accompanied by diabetic ketoacidosis; a case report. Arch Acad Emerg Med. 2022;10:368.","journal-title":"Arch Acad Emerg Med"}],"container-title":["JA Clinical Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-025-00792-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40981-025-00792-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-025-00792-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T08:58:09Z","timestamp":1747472289000},"score":1,"resource":{"primary":{"URL":"https:\/\/jaclinicalreports.springeropen.com\/articles\/10.1186\/s40981-025-00792-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,17]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["792"],"URL":"https:\/\/doi.org\/10.1186\/s40981-025-00792-x","relation":{},"ISSN":["2363-9024"],"issn-type":[{"value":"2363-9024","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,17]]},"assertion":[{"value":"1 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 May 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 May 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"28"}}