Journal of Universal Surgery

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Post-Op Hamman�?¢�?�?��?�?�s Sign: A Case Report

John Michael DiBianco, Archana Nair, Richard Williams

Introduction: We provide this brief case report on Hamman’s sign, as a reminder that both pneumomediastinum and pneumothorax can cause sounds that may disclose the abnormal presence of air in these respective locations. Attributed originally to the observations and report of Louis Hamman in 1937, abnormal sounds may emanate from air in the otherwise quiet mediastinum. Others have emphasized that air in the pleural space may also create abnormal sounds.

Case Presentation: Our patient, a 36 year old Caucasian male, reported the occurrence of an abnormal “rhythmic clicking” sound emanating from his upper body when lying on his left side, following nasal septal surgery. The patient’s clear report of particularly loud sounds, beginning post-operatively, was corroborated by the patient’s wife and prompted a CT scan of the chest which confirmed the presence of free air in the left hemithorax.

Conclusions: The presence of a sound, loud enough to be heard at a distance from the patient (corroborated by another individual) is an unusual and to our knowledge previously unreported finding of pneumothorax. The value of patient history is underscored by the finding of a pneumothorax, suggesting Hamman’s sign.