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Subcutaneous Emphysema: Symptoms, Causes and Treatment

Subcutaneous Emphysema: Symptoms, Causes and Treatment

The skin is an organ composed of multiple layers that can vary according to their thickness and color, in addition to presenting glands and hairs. The most superficial layer is the epidermis, followed by an intermediate layer called the dermis and a deeper layer, which is the hypodermis. The deeper layer is also called subcutaneous tissue, which allows the skin to move and inside it contains a series of structures such as nerves, blood vessels, glands, among others. Like any part of the body, the hypodermis is susceptible to diseases, one of which could be subcutaneous emphysema, a condition in which air is trapped in this layer of the skin, producing a series of symptoms.



What is Subcutaneous Emphysema?

Subcutaneous emphysema is a smooth-looking bump or swelling located on the skin that is caused by the penetration of air into the tissues. It is more common to observe this type of emphysema in the skin that lines the rib cage, face or neck, although it can also be observed in other regions of the human body.


subcutaneous emphysema
subcutaneous emphysema

When you have an emphysema you can observe a series of clinical manifestations such as swelling or inflammation of the area or pain, as well as other characteristics, thanks to which it can be diagnosed correctly. However, in other circumstances it is usually difficult to diagnose, since the signs and symptoms of this condition can not be detected. It is a generally aesthetic problem and that usually does not have complications, unless it is a severe case with possible inconvenience.



Causes of Subcutaneous Emphysema

The causes of subcutaneous emphysema can be diverse, its appearance can be generated even by a complication during a procedure in which health is altered, causing an increase in lung pressure in the tissues, however, the most common causes of subcutaneous emphysema are the following:

  • Injuries: Injuries as by firearms or by sharp objects.
  • Fractures such as facial bone.
  • Pulmonary or esophagus ruptures.
  • Excessive pressure due to severe vomiting (Boerhaave syndrome).
  • Infections such as gas gangrene.
  • For dental procedures through equipment containing compressed air.
  • After a laparoscopic surgery such as appendicitis.



Symptoms of Subcutaneous Emphysema

The doctor will detect the presence of pulmonary emphysema first by clinical inspection and followed by palpation in which the protuberance is determined. During palpation there will be a sensation known as crepitus or crunching, product of the push of the air inside the tissues. In addition to this, inflammation or swelling of the area and even of the entire face will be observed, commonly in the neck, which is the place with the greatest frequency of appearance. The affected person reports having chest pain because of its location in the rib cage or pain in the throat when it is located in the neck.



When subcutaneous emphysema produces swelling in the neck area, in turn it will cause difficulty in swallowing, because of the sensation of pain. Added to this there is:

  • Wheezing when the person breathes.
  • Changes in the voice
  • Difficulty breathing


Treatment of Subcutaneous Emphysema

This disease is considered benign and usually does not have complications in the vast majority of cases. This condition usually does not need treatment, except for the treatment of underlying causes that may cause it, in addition to controlling other symptoms that may appear as asthma, malaise and respiratory problems.



When there is a complication known as massive subcutaneous emphysema, it will require the application of a more complex procedure such as surgical drainage. If this emphysema becomes severe, catheters can be used on the skin to release the compressed air.



Making small cuts on the affected skin helps improve the condition because it removes the air contained in the area. Drugs should be used to alleviate the pain generated as an additional symptom and in those severe cases with difficulty breathing, supplemental oxygen will be administered, this also cooperates with the body in absorbing the air under the skin quickly. If emphysema causes necrosis in certain regions, decompression is necessary.


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