Reported here is a rare respiratory complication in a young primiparous woman in a remote community hospital in the Northern Territory, Australia. A Caucasian primiparous woman aged 23 years presented with chest pain following a very prolonged second stage of labour. On clinical examination a crunching and crackling sound was heard over the precordium, synchronous with the heartbeat (Hamman's sign). A chest radiograph confirmed the presence of pneumomediastinum. Complete resolution of symptoms and signs was achieved with supportive management.
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