Mediastinal Crunch: Causes & Reasons

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Possible Causes for Mediastinal Crunch

Esophageal Perforation

Mid-thoracic esophageal perforation presents with subternal or epigastric pain; mediastinal crunch is rarely auscultated. Mackler’s triad. [clinicaladvisor.com]

Physical Examination: Cardiac: possible Hamman’s crunch. Abdomen: may encounter guarding or rigidity (intra-abdominal rupture). [emdocs.net]

Upper thoracic perforation commonly presents with right-sided pleural effusion, but may also be associated with substernal and epigastric pain; audible mediastinal crunch [clinicaladvisor.com]

Subcutaneous Emphysema

There was no mediastinal crunch. Classical cavernous type of breathing was present in right infraclavicular area. [lungindia.com]

Mediastinal Emphysema

Physical examination may show respiratory distress, neck crepitus, decreased cardiac dullness, Hamman’s sign (a mediastinal crunching sound that is synchronized with systole [kjim.org]

Acute Mediastinitis

A pericardial crunching sound with systole (Hamman’s sign) is often a late sign. [for-surgeons.com]

Hamman's sign (a crunching sound synchronous with cardiac systole, heard over the anterior thorax) is characteristic but not always present. [slideshare.net]

About 60% of patients with acute mediastinitis have subcutaneous emphysema or pneumomediastinum. [for-surgeons.com]

Mediastinal Abscess

Auscultation of the heart may reveal a crunching sound. [ 1 ] Differential diagnosis Pulmonary embolism. Myocardial infarction. [patient.info]

Spontaneous pneumomediastinum. [ 9 ] Mediastinal tumour and/or superior vena cava syndrome. Cellulitis of the neck. Necrotising fasciitis affecting the neck. [patient.info]

Rib Fracture

A rib fracture is a break in a rib bone. This typically results in chest pain that is worse with breathing in. Bruising may occur at the site of the break. When several ribs are broken in several places a flail chest results. Potential complications include a pneumothorax, pulmonary contusion, and pneumonia.Rib[…] [en.wikipedia.org]

Sternal Fracture

BACKGROUND: The assessment of the sternal fracture and concomitant injuries is discussed. METHODS: Two hundred sternal fractures were analyzed with respect to accident circumstances, fracture morphology and topography, and associated injuries. RESULTS: Traffic accidents were frequent; 89.2% of them were[…] [ncbi.nlm.nih.gov]

Mediastinoscopy

The feasibility of cervical mediastinoscopy after total laryngectomy and radiotherapy has not been documented. We describe our experience with cervical mediastinoscopy in two patients with total laryngectomy and radiotherapy for squamous cell carcinoma and had a Blom-Singer speaking tracheostomy valve in situ.[…] [ncbi.nlm.nih.gov]

Flail Chest

PURPOSE: Flail chest (FC) injuries represent a significant burden on trauma services because of its high morbidity and mortality. Current gold standard conservative management strategies for FC, are now being challenged by renewed interest in surgical rib fixation. This retrospective epidemiological study sets out[…] [ncbi.nlm.nih.gov]

Thoracic Surgery

Surgery for patients with left central bronchogenic carcinoma invading the carina is challenging due to the complexity of left sleeve pneumonectomy, carinal resection, and airway reconstruction and management. Here we describe a modified approach to overcome this problem. Between March 2011 and September 2012, two[…] [ncbi.nlm.nih.gov]

Penetrating Chest Trauma

BACKGROUND: Penetrating injuries to the chest present a frequent and challenging problem, but the majority of these injuries can be managed non-\operatively. The aim of this study was to describe the incidence of penetrating chest trauma and the ultimate techniques used for operative management, as well as the[…] [ncbi.nlm.nih.gov]

Tracheal Injury

On physical exam, pertinent findings include stridor, cyanosis, dyspnea, voice changes/hoarseness, subcutaneous emphysema, mediastinal crunch on auscultation. [ncbi.nlm.nih.gov]

Pulmonary Cavitary Tuberculosis

There was no mediastinal crunch. Classical cavernous type of breathing was present in right infraclavicular area. [lungindia.com]

Mallory-Weiss Syndrome

And when the doctor places the sthetoscope on the pt's chest, he'll hear a crunching sound (Hamman's mediastinal crunch) that results from air dissecting subq???? [prep4usmle.com]

Pulmonary Consolidation

One important nonpulmonary sound is a mediastinal crunch, caused by pneumomediastinum. [emedicine.medscape.com]

HAMMAN'S SIGN: Crunching, crackling sound over chest heard synchronous with the heart beat. Occurs with mediastinal emphysema -- air in the mediastinum. [kumc.edu]

Alveolar Rupture

Physical examination may show respiratory distress, neck crepitus, decreased cardiac dullness, Hamman’s sign (a mediastinal crunching sound that is synchronized with systole [kjim.org]

Pneumopericardium

Physical examination may show respiratory distress, neck crepitus, decreased cardiac dullness, Hamman’s sign (a mediastinal crunching sound that is synchronized with systole [kjim.org]

Laryngospasm

Conditions pleural effusion pneumothorax Mediastinal Crunch (Hamman’s sign) Mediastinal crunches are crackles that are synchronized with the heart beat and not respiration [reocities.com]

As with stridor, mediastinal crunches should be treated as medical emergencies. [reocities.com]

Traumatic Neck Injury

crunch (Hamman crunch) Intercostal retractions Decreased breath sounds Hyperresonance to percussion of the contralateral hemithorax, associated with hyperinflation of the [emedicine.medscape.com]

[…] emphysema Cough Respiratory distress Hemoptysis, usually secondary to a disrupted bronchial artery Tension pneumothorax Continuous air leak persisting after chest tube insertion Mediastinal [emedicine.medscape.com]

Crack Lung

crunch) discontinuous neither (heartbeat) crunching, rasping pneumomediastinum, pneumopericardium not available Continued [ edit ] Rales: Small clicking, bubbling, or rattling [en.wikipedia.org]

[…] friction rub discontinuous low inspiratory and expiratory nonmusical, many repeated rhythmic sounds inflammation of lung linings, lung tumors not available Hamman's sign (or Mediastinal [en.wikipedia.org]

Presbyesophagus

Examination may demonstrate subcutaneous emphysema in the neck and a mediastinal crunch on auscultation. [mycourses.med.harvard.edu]

Frank mediastinal air, extending into the neck and chest wall when severe, or air-fluid levels are less commonly seen. [mycourses.med.harvard.edu]

Acute mediastinitis usually presents with severe retrosternal chest pain, high fever often with sepsis. Dysphagia is usually present. [mycourses.med.harvard.edu]

Chest Wall Injury

• Dyspnea, Pneumothorax, hemoptysis, Mediastinal crunch {Hamman’s Sign}, Intercostal retractions, Respiratory distress, Stridor. • Chest drain will reveal a large air leak [slideshare.net]

Ventilation Pneumonitis

Hamman's sign ("mediastinal crunch") present in up to 50% In infants can be achieved by insertion of a small catheter into anterior mediastinum while in adults most efficient [aic.cuhk.edu.hk]

Laceration of the Lung

May also demonstrate a mediastinal "crunch" from subcutaneous emphysema. Pneumomediastinum can be seen on chest X-ray. [clinicaladvisor.com]

Chest Trauma

• Dyspnea, Pneumothorax, hemoptysis, Mediastinal crunch {Hamman’s Sign}, Intercostal retractions, Respiratory distress, Stridor. • Chest drain will reveal a large air leak [slideshare.net]

Ludwig's Angina

[…] of mediastinal crepitation or a mediastinal crunch. [pmaksimovich.tripod.com]

The patient with mediastinitis will often report increasing neck pain, chest tightness, and increasing dyspnea. [pmaksimovich.tripod.com]

Later findings of mediastinal extension include increasing signs of septic shock with tachycardia and decreasing blood pressure, crepitation of the lower neck, or development [pmaksimovich.tripod.com]

Mechanical Ventilation

Hamman's sign ("mediastinal crunch") present in up to 50% In infants can be achieved by insertion of a small catheter into anterior mediastinum while in adults most efficient [aic.cuhk.edu.hk]

Mirhosseini-Holmes-Walton Syndrome

crunch see Hamman sign positive Mediastinal emphysema see Pneumomediastinum Mediastinal enlargement Mediastinal fibrosis see Sclerosing mediastinitis Mediastinal granuloma [diseasesdatabase.com]

Mecysteine see Methylcysteine Medazepam Medial calcific sclerosis see Mönckeberg arteriosclerosis Medial epicondylitis of elbow see Golfer elbow Median rhomboid glossitis Mediastinal [diseasesdatabase.com]

Medial Sclerosis

Hamman's sign (a crunching sound synchronous with cardiac systole, heard over the anterior thorax) is characteristic but not always present. [slideshare.net]

Auscultation of the heart may reveal a crunching sound.[1] Differential diagnosis Pulmonary embolism. Myocardial infarction. [patient.info]

It may be difficult to determine mediastinal involvement based on history and exam findings. [infectiousdiseaseadvisor.com]

Mediastinitis

Hamman's sign (a crunching sound synchronous with cardiac systole, heard over the anterior thorax) is characteristic but not always present. [de.slideshare.net]

Auscultation of the heart may reveal a crunching sound.[1] Differential diagnosis Pulmonary embolism. Myocardial infarction. [patient.info]

Later, tracheal deviation, jugular venous distention, and other signs of compression of mediastinal structures may appear. 5. [de.slideshare.net]