title: Post-operative Hamman's sign: a case report.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
authors: Ross University School of Medicine, Roseau, Commonwealth of Dominica, West Indies.
authors: John Michael
authors: 0000-0002-4031-873X
authors: JM
authors: DiBianco
authors: Department of Internal Medicine, MedStar Harbor Hospital 3001 S. Hanover St., Baltimore, MD 21225 USA.
authors: Archana
authors: A
authors: Nair
authors: Department of Internal Medicine, MedStar Harbor Hospital 3001 S. Hanover St., Baltimore, MD 21225 USA.
authors: Richard
authors: R
authors: Williams
keywords: Hamman’s sign; Pneumothorax; Precordial sounds