Post-operative Hamman’s sign: a case report

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. BACKGROUND: Attributed originally to the observations and report of Louis Hamman in 1937, abnormal sounds may emanate from air in the otherwise quiet mediastinum or pleural space. CASE PRESENTATION: Our patient, a 36 year old white male, reported the occurrence of an abnormal “rhythmic clicking” sound emanating from his upper body when lying on his left side, 3 weeks following nasal septal surgery. The patient’s clear report of particularly loud sounds, beginning post-operatively, was corroborated by the patient’s wife. A CT scan of the chest which confirmed the presence of air in the left pleural space. CONCLUSIONS: The presence of a sound, loud enough to be heard at a distance from the patient (corroborated by another individual) is unusual. The value of patient history is underscored by the finding of a pneumothorax, suggesting Hamman’s sign.