BMJ Case Reports 2018; doi:10.1136/bcr-2018-225099
  • Images in…

Hamman’s crunch: a forgotten clue to the diagnosis of spontaneous pneumomediastinum

  1. Pedro Raimundo
  1. Departamento de Medicina Interna e Medicina Intensiva, Hospital da Luz Lisboa, Lisboa, Portugal
  1. Correspondence to Dr Pedro Raimundo, p_oliveiraraimundo{at}
  • Accepted 21 March 2018
  • Published 9 April 2018


A 23-year-old Caucasian woman with a thin and tall body habitus presented to the emergency department with dizziness and chest pain. The pain had begun 12 hours before presentation without relation to exertion or trauma, radiating continuously to the neck and dorsum and being exacerbated by coughing or taking deep breaths.

The patient was previously healthy except for an episode of flu-like illness 2 weeks before presentation. She was not taking any medication and was a non-smoker. She had no relevant family history.

On clinical examination, she was conscious and reactive, afebrile and haemodynamically stable. She was eupnoeic and her oxygen saturation on pulse oximetry was 100%. Her breath sounds were normal on pulmonary auscultation, …

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