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.