Hamman's sign

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Hamman's sign
Differential diagnosis pneumomediastinum

Hamman's sign (rarely, Hammond's sign [1] or Hammond's crunch [2] ) is a medical sign consisting of a crunching, rasping sound, synchronous with the heartbeat, [3] heard over the precordium in spontaneous mediastinal emphysema. It is thought to result from the heart beating against air-filled tissues.

Contents

It is named after Johns Hopkins clinician Louis Hamman, M.D. [4]

This sound is heard best over the left lateral position. [5] It has been described as a series of precordial crackles that correlate with the heart beat rather than respiration.

Causes

Hamman's crunch is caused by pneumomediastinum or pneumopericardium, and is associated with tracheobronchial injury [6] due to trauma, medical procedures (e.g., bronchoscopy) or rupture of a proximal pulmonary bleb. It can be seen with Boerhaave syndrome.

See also

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<span class="mw-page-title-main">Subcutaneous emphysema</span> Abnormal presence of air or gas under the skin

Subcutaneous emphysema occurs when gas or air accumulates and seeps under the skin, where normally no gas should be present. Subcutaneous refers to the subcutaneous tissue, and emphysema refers to trapped air pockets. Since the air generally comes from the chest cavity, subcutaneous emphysema usually occurs around the upper torso, such as on the chest, neck, face, axillae and arms, where it is able to travel with little resistance along the loose connective tissue within the superficial fascia. Subcutaneous emphysema has a characteristic crackling-feel to the touch, a sensation that has been described as similar to touching warm Rice Krispies. This sensation of air under the skin is known as subcutaneous crepitation, a form of crepitus.

<span class="mw-page-title-main">Sternal fracture</span> Medical condition

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<span class="mw-page-title-main">Tracheobronchial injury</span> Damage to the tracheobronchial tree

Tracheobronchial injury is damage to the tracheobronchial tree. It can result from blunt or penetrating trauma to the neck or chest, inhalation of harmful fumes or smoke, or aspiration of liquids or objects.

<span class="mw-page-title-main">Diaphragmatic rupture</span> Tear in the thoracic diaphragm

Diaphragmatic rupture is a tear of the diaphragm, the muscle across the bottom of the ribcage that plays a crucial role in breathing. Most commonly, acquired diaphragmatic tears result from physical trauma. Diaphragmatic rupture can result from blunt or penetrating trauma and occurs in about 0.5% of all people with trauma.

<span class="mw-page-title-main">Scapular fracture</span> Injury of the shoulder blade

A scapular fracture is a fracture of the scapula, the shoulder blade. The scapula is sturdy and located in a protected place, so it rarely breaks. When it does, it is an indication that the individual was subjected to a considerable amount of force and that severe chest trauma may be present. High-speed vehicle accidents are the most common cause. This could be anywhere from a car accident, motorcycle crash, or high speed bicycle crash but falls and blows to the area can also be responsible for the injury. Signs and symptoms are similar to those of other fractures: they include pain, tenderness, and reduced motion of the affected area although symptoms can take a couple of days to appear. Imaging techniques such as X-ray are used to diagnose scapular fracture, but the injury may not be noticed in part because it is so frequently accompanied by other, severe injuries that demand attention. The injuries that usually accompany scapular fracture generally have the greatest impact on the patient's outcome. However, the injury can also occur by itself; when it does, it does not present a significant threat to life. Treatment involves pain control and immobilizing the affected area, and, later, physical therapy.

References

  1. Shabetai, Ralph (2003-10-31). The Pericardium - Google Book Search. Springer. ISBN   9781402076398 . Retrieved 2008-11-26.
  2. Hadjis T, Palisaitis D, Dontigny L, Allard M (March 1995). "Benign pneumopericardium and tamponade". Can J Cardiol. 11 (3): 232–4. PMID   7889442.
  3. "Hamman sign" at Dorland's Medical Dictionary
  4. synd/3001 at Who Named It?
  5. McCann], [executive publisher, Judith A. Shilling (2008). Nursing. Ambler, PA: Lippincott Williams & Wilkins. p. 171. ISBN   9781582556680.{{cite book}}: CS1 maint: multiple names: authors list (link)
  6. . Chu CP, Chen PP (April 2002). "Tracheobronchial injury secondary to blunt chest trauma: Diagnosis and management". Anaesth Intensive Care. 30 (2): 145–52. doi: 10.1177/0310057X0203000204 . PMID   12002920.