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] 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] 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] 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 Background Surgical treatment of broken ribs uses titanium plates to stabilize fractured ribs while they heal and hold the ribs in their correct anatomic location. Fractured ribs, also referred to as broken or cracked ribs, are common in blunt chest wall trauma and active lifestyle injuries from cycling to football.[…] [depuysynthes.com] Sternal Fracture II. Epidemiology Uncommon injury associated with Blunt Chest Trauma Typical patient is an older male IV. Precautions Sternal Fracture is a marker of significant blunt force to the chest V. Imaging Chest XRay Poor Test Sensitivity for Sternal Fracture CT chest Sternal Fractures may be difficult to identify even on CT[…] [fpnotebook.com] Mediastinoscopy Mediastinoscopy has traditionally been the gold standard for assessing whether cancer has gone to the mediastinal lymph nodes (mediastinum is the space between the lungs that contains the heart, esophagus and airway). Mediastinoscopy is also used to biopsy a mediastinal mass or enlarged lymph nodes to check for[…] [dignityhealth.org] Flail Chest Plastic surgeons specialize in working closely with other surgical colleagues to help solve clinical problems. In this case, we performed surgical stabilisation of a large flail chest fragment in conjunction with the cardiothoracic surgical team, using the mini-plating set more commonly used for hand fracture fixation. The[…] [ncbi.nlm.nih.gov] Thoracic Surgery Pulmonary hamartoma is the most common benign tumor of the lung. It accounts for 77% of all benign lung tumors but less than 1% of all lung tumors. Malignant alteration is -extremely rare. Surgical removal is therapy of choice. Uniportal video-assisted thoracic surgery is an easy-to-learn variant of video-assisted[…] [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] 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] 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] 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] 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] 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] 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] 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] 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] 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] Laceration of the Lung May also demonstrate a mediastinal "crunch" from subcutaneous emphysema. Pneumomediastinum can be seen on chest X-ray. [clinicaladvisor.com] 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] 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] 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] 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] 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] Staghorn Calculus Asymmetric breath sounds and tracheal deviation with hypoxia should prompt evaluation for pneumothorax Mediastinal crunch or crepitus on exam around neck or chest indicate [ncbi.nlm.nih.gov]
