Post-operative Hamman's sign: a case report.

Area of Science:

• Medical Case Reports
• Pulmonology
• Diagnostic Signs

Background:

• Hamman's sign, described in 1937, refers to abnormal sounds from air in the mediastinum or pleural space.
• Pneumomediastinum and pneumothorax are conditions where air abnormally collects in these spaces, often producing audible sounds.
• These signs can be crucial auditory clues for diagnosing thoracic air leaks.

Purpose of the Study:

• To report a case of Hamman's sign in a patient experiencing audible chest sounds post-surgery.
• To underscore the diagnostic value of patient-reported auditory symptoms in identifying pneumothorax.
• To remind clinicians of the potential for pneumomediastinum and pneumothorax to present with distinct sounds.

Main Methods:

• A case report detailing a 36-year-old male patient with a "rhythmic clicking" sound after nasal septal surgery.
• Patient history and corroboration by a spouse were key components of the initial assessment.
• A CT scan of the chest was performed to confirm the presence of air in the pleural space.

Main Results:

• The patient reported loud, rhythmic clicking sounds originating from his upper body, particularly when lying on his left side.
• These sounds began approximately three weeks after nasal septal surgery.
• A chest CT scan confirmed the presence of air in the left pleural space, indicative of a pneumothorax.

Conclusions:

• The occurrence of sounds loud enough to be heard by another person is an unusual presentation of Hamman's sign.
• This case highlights the critical role of detailed patient history in diagnosing conditions like pneumothorax.
• Hamman's sign, though rare, remains a valuable clinical finding suggestive of thoracic air presence.