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Case Studies | Medicine | India | Volume 14 Issue 2, February 2025 | Rating: 5.3 / 10
A Rare Presentation of Subcutaneous Emphysema Secondary to Blunt Trauma Chest
Dr. Simran Shakya, Dr. Sayantan Mukherjee, Dr. Shashwat Jindal, Dr. Sheenam Gupta
Abstract: Subcutaneous emphysema is the de novo generation or infiltration of air underneath the dermal layers of skin. The development of subcutaneous air may be a benign symptom or an indication of a deeper, more concerning pathologic disease state. The most common and visible sign and symptom of SE is swelling around the neck accompanied with pain in the chest. Other signs and symptoms include tender sore throat, aching neck, difficulty in swallowing, breathlessness, wheezing, and distension. So, it often causes minimal symptoms, is not dangerous in itself, and requires no specific treatment. We classify the severity of SE based on anatomical extension into five grades including the (1) base of the neck, (2) all of the neck area, (3) subpectoralis major area, (4) chest wall and all of the neck area, and (5) chest wall, neck, orbit, scalp, abdominal wall, upper limbs, and scrotum (2). Tracheal rupture is a rare but life - threatening complication that most commonly occurs after blunt trauma of the neck and chest. Iatrogenic rupture is extremely rare and can occur after intubation, bronchoscopy, or esophagectomy. Recently spontaneous tension pneumomediastinum (PTM), pneumothorax (PT), and subcutaneous emphysema (SE) were reported as infrequent complications in COVID - 19 patients. Early diagnosis and treatment could save the patients since these complications are related to poor prognosis and prolonged hospitalization. Air expansion can involve subcutaneous and deep tissues, with the non - extensive subcutaneous spread being less concerning for clinical deterioration. However, the development of subcutaneous emphysema may indicate that air is occupying another deeper area within the body not visible to the unaided eye. Air extravasation in other body cavities and spaces can cause pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and pneumothorax. Subcutaneous emphysema is a rare complication of acute severe asthma that may occur in association with spontaneous pneumomediastinum, pneumopericardium or pneumoperitoneum. Spontaneous pneumomediastinum arises as a result of sudden rise in intra - alveolar pressure (asthma, vasalva manouvre, cough, emesis, barotraumas) resulting in the rupture of marginal alveoli and subsequent tracking of air along bronchi, interstitial and vascular support tissues into the mediastinum.
Keywords: Subcutaneous emphysema, Blunt trauma, Chest trauma, Strangulation
Edition: Volume 14 Issue 2, February 2025,
Pages: 288 - 291