Possible Causes for mediastinal crunch Subcutaneous Emphysema There was no mediastinal crunch. Classical cavernous type of breathing was present in right infraclavicular area. [lungindia.com] Rib Fracture Rib fractures pose significant risk to trauma patients. Effective pain control and the ability to take deep breaths are crucial for optimal recovery, and these are key elements in current clinical guidelines. These guidelines use incentive spirometry volumes along with other assessment values to guide patient care.[…] [ncbi.nlm.nih.gov] Sternal Fracture BACKGROUND: Multidetector CT (MDCT) is being increasingly used for patients with traumatic injuries in the emergency room. This is the first study to evaluate the diagnostic performance of MDCT for sternal fracture. PATIENTS AND METHODS: For 87 patients who had motor vehicle accidents, we evaluated the[…] [ncbi.nlm.nih.gov] 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] 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] 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] 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] Flail Chest On rare occasions after total sternectomy, patients develop persistent flail chest deformities requiring long-term mechanical respiratory assistance. We report the use of a temporary external chest shell to deliver constant negative extrathoracic pressure (CNEP) to a long-term ventilated patient with flail chest.[…] [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] 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] Preeclampsia 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] 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] Streptococcus Pneumoniae 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] 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] Uremic Pneumonitis HAMMAN'S SIGN: Crunching, crackling sound over chest heard synchronous with the heart beat. Occurs with mediastinal emphysema -- air in the mediastinum. [kumc.edu] 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] 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] 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] 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] Status Epilepticus 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] 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] Status Asthmaticus 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] Arterial Embolism Mediastinal and subcutaneous emphysema, due to bubbling in the tissues, cause substernal pain, subcutaneous crepitus (a crunching feeling ), a definite x-ray appearance and [scuba-doc.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] Tracheal Injury On physical exam, pertinent findings include stridor, cyanosis, dyspnea, voice changes/hoarseness, subcutaneous emphysema, mediastinal crunch on auscultation. [ncbi.nlm.nih.gov] 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] 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]
