What is Subcutaneous Emphysema?

The causes and treatments for subcutaneous emphysema.

Subcutaneous emphysema varies greatly from other forms of emphysema in a variety of different ways. It is not typically caused by smoking and it is treated in a completely different fashion from standard emphysema. Though it is rare, subcutaneous emphysema is a dangerous condition that requires immediate medical attention.

The definition and cause of subcutaneous Emphysema

When air gets under the skin of the neck or chest subcutaneous emphysema can occur. Typically this is caused by some type of trauma like a gun shot, stab wound or blunt force injury. Collapsed lungs, ruptured esophagus and ruptured bronchial tubes also can contribute to the development of subcutaneous emphysema. This condition can also occur when a patient in critical condition is intubated to aid their breathing.

Subcutaneous emphysema can also appear on other parts of the body as a result of severe bacterial infections and gas gangrene.

Symptoms and Treatments of Subcutaneous Emphysema

Often when a person is experiencing subcutaneous emphysema they will see a bulging of the skin on their chest or neck.  When probed carefully by a health care worker a subcutaneous emphysema bulge will make an odd noise.  This condition may also cause pain, difficulty breathing, rapid breathing, coughing, difficulty swallowing and reduced breath sounds.

To treat this condition doctors often recommend constant bed rest along with careful observation. They may also perform a battery of other tests to rule out other injuries, complications and a condition called arterial gas embolism. These two conditions often go hand and hand, so it is important that this is ruled out before preceding with care.  Subcutaneous emphysema is not a chronic condition and with proper care it can be resolved.

When subcutaneous emphysema is caused by pneumothorax or a collection of air or gas in the surrounding area around the lungs, the care required is different then that of other types.  Lung diseases caused by smoking like COPD can cause a pneumothorax. Asthma, cystic fibrosis, TB, whooping cough and trauma to the chest can all cause this condition as well. The symptoms of subcutaneous  emphysema caused by pneumothorax are chest pain, chest tightness, fatigue, rapid heart rate, shortness of breath and blue skin caused by a lack of oxygen.

Although some may go away on their own others require removal of the build up of air in the chest cavity. Doctors use a chest tube, placed in the chest wall between the ribs. This allows the patients lungs to expand and fill with oxygen. Depending on the severity of the problem, the chest tube will either be removed right away or be left in for several days.

Generally, once all issues surrounding subcutaneous emphysema or a pnuemothorax are resolved most patients will make a complete recovery. Typically, no long term complications will result from either of these conditions. However, both of these conditions are severely life threatening and if you suspect that you have developed either you should seek emergency medical assistance immediately.