18 Facts About Subcutaneous emphysema

Subcutaneous emphysema occurs when gas or air accumulates and seeps under the skin, where normally no gas should be present.

Subcutaneous refers to the subcutaneous tissue, and emphysema refers to trapped air pockets resembling the pneumatosis seen in pulmonary emphysema.

Since the air generally comes from the chest cavity, subcutaneous emphysema usually occurs around the upper torso, such as on the chest, neck, face, axillae and arms, where it is able to travel with little resistance along the loose connective tissue within the superficial fascia.

Subcutaneous emphysema has a characteristic crackling-feel to the touch, a sensation that has been described as similar to touching warm Rice Krispies.

Subcutaneous emphysema can be caused by medical procedures and medical conditions that cause the pressure in the alveoli of the lung to be higher than that in the tissues outside of them.

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Subcutaneous emphysema is not typically dangerous in and of itself, however it can be a symptom of very dangerous underlying conditions, such as pneumothorax.

Subcutaneous emphysema is often found in car accident victims because of the force of the crash.

Subcutaneous emphysema is a common result of certain types of surgery; for example it is not unusual in chest surgery.

When emphysema occurs due to infection, signs that the infection is systemic, i e that it has spread beyond the initial location, are present.

Spontaneous subcutaneous emphysema is thought to result from increased pressures in the lung that cause alveoli to rupture.

Significant cases of subcutaneous emphysema are easy to diagnose because of the characteristic signs of the condition.

Subcutaneous emphysema can be seen in CT scans, with the air pockets appearing as dark areas.

Subcutaneous emphysema can be a complication of CO2 insufflation with laparoscopic surgery.

When subcutaneous emphysema occurs due to pneumothorax, a chest tube is frequently used to control the latter; this eliminates the source of the air entering the subcutaneous space.

Once the pneumothorax or pneumomediastinum that causes the subcutaneous emphysema is resolved, with or without medical intervention, the subcutaneous emphysema will usually clear.

In 1900, the first recorded case of spontaneous subcutaneous emphysema was reported in a bugler for the Royal Marines who had had a tooth extracted: playing the instrument had forced air through the hole where the tooth had been and into the tissues of his face.

Since then, another case of spontaneous subcutaneous emphysema was reported in a submariner for the US Navy who had had a root canal in the past; the increased pressure in the submarine forced air through it and into his face.

The cause of spontaneous subcutaneous emphysema was clarified between 1939 and 1944 by Macklin, contributing to the current understanding of the pathophysiology of the condition.