Subcutaneous emphysema

Definition

Subcutaneous emphysema occurs when air gets into tissues under the skin. This usually occurs in the skin covering the chest wall or neck, but can also occur in other parts of the body.

Alternative Names

Crepitus; Subcutaneous air; Tissue emphysema

Considerations

Subcutaneous emphysema can often be seen as a smooth bulging of the skin. When a health care provider feels (palpates) the skin, it produces an unusual crackling sensation as the gas is pushed through the tissue.

Causes

This is a rare condition. When it does occur, possible causes include:

• Collapsed lung (pneumothorax), often occurring with a rib fracture
• Facial bone fracture
• Ruptured bronchial tube
• Ruptured esophagus

This condition can happen due to:

• Blunt trauma
• Forceful vomiting" (Boerhaave's syndrome)
• Gun shot wounds
• Stabbing
• Rarely after medical procedures such as endoscopy, a central venous line, intubation, and bronchoscopy

Air can also be found in between skin layers on the arms and legs or torso during certain infections, including gas gangrene.

When to Contact a Medical Professional

Most of the conditions that cause subcutaneous emphysema are very severe. Sometimes a hospital stay is needed. Medical staff should already be involved in most cases.

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