Hamman’s sign – Knowledge and References

Hamman's sign

Hamman's sign refers to a crunching sound that is heard during systolic activity of the heart, which is caused by the presence of intrapericardial or intramediastinal air. It may be accompanied by symptoms such as fever, chills, subcutaneous emphysema, abdominal tenderness, and mediastinal crunching upon auscultation of the chest.From: Comprehensive Reviews in Toxicology [2019], Case Histories for the MRCP [2019], Complications in Surgery and Trauma [2014]

Complications of Esophageal Surgery and Trauma

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Published in Stephen M. Cohn, Matthew O. Dolich, Complications in Surgery and Trauma, 2014

Peter P. Lopez, Joseph R. Buck, Lawrence N. Diebel

Clinical signs and symptoms are present among as many as 80% of patients with traumatic esophageal injuries. These signs and symptoms include odynophagia, dysphagia, hematemesis, shortness of breath, cervical crepitus, cough, stridor, complaints of neck and chest pain, hoarseness, and bleeding from the oropharynx. Fever, chills, subcutaneous emphysema, abdominal tenderness, and mediastinal crunching upon auscultation of the chest (Hamman’s sign) may be present. Clinical findings of pneumothorax, pneumomediastinum, left-sided pleural effusion, a nasogastric tube passing into the pleural space, food particles draining from a chest tube, or bubbles in the chest tube through both inspiration and expiration may suggest esophageal injury.

Pneumomediastinum in late pregnancy: a case report and review of the literature

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Journal Information

Published in Acta Chirurgica Belgica, 2023

N. Zonnebeld, P. P. H. L. Broos, S. M. E. Engelen, Y. L. J. Vissers, E. R. de Loos

Complaints after vomiting are retrosternal chest and upper abdominal pain, which can be accompanied by subcutaneous emphysema (i.e. Mackler’s triad). After rupture, other complaints caused by gastric spilling into the mediastinum can develop (e.g. tachypnea, fever, and shock). Mackler’s triad is only present in 14% of patients. Additionally, Hamman’s sign – a crunching sound synchronous with the heartbeat, caused by the heart beating against air-filled tissue – can be observed.

Hamman's sign

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