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Subcutaneous Emphysema

Subcutaneous Emphysema

Subcutaneous emphysema is a medical condition wherein gas or air gets trapped in the subcutaneous layer of the skin. This write-up provides information on the causes, symptoms, and treatment of this condition.
Smita Pandit
Subcutaneous emphysema, also known as tissue emphysema, occurs when air seeps into the subcutaneous layer of the skin. The buildup of air or gases under the skin lends a bloated appearance to the affected part of the body. The displaced and trapped air often comes from the chest cavity, which is why this condition generally affects the chest, neck, or face. This condition could be characterized by subcutaneous crepitation, which refers to the crackling sound that is heard when the skin is touched.
Causes
This condition could be caused due to a wide range of reasons. For instance, air could seep through the lacerations on the skin that may have been caused due to injuries. Bullet wounds, surgical wounds, or any type of blunt trauma to the skin can make one susceptible to this condition. It could occur due to gas gangrene, which is a serious infection on wounded skin that leads to tissue death. Air could also get displaced due to trauma to the trachea or bronchial tubes during a medical procedure called bronchoscopy or while placing a breathing tube. At times, infections may also cause damage to the respiratory organs and affect their function.
Pneumothorax is considered to be one of the major contributing factors. The lungs are lined by pleura, which is a two-layered serous membrane. The inner serous membrane is attached to the lungs, while the outer membrane attaches to the chest wall. The pleural space, that is space between these two membranes, is normally filled with a fluid. If the air-filled sacs present in the lungs rupture, then air starts leaking from the sacs into the pleural space. This causes pressure to build up and causes the lungs to collapse partially or completely. This condition is medically referred to as pneumothorax. It can cause displacement of air to the subcutaneous layer of the skin. It has been observed that pneumothorax that occurs with rib fracture increases the risk of this condition to a great extent.
Treatment
Unlike pulmonary emphysema, which is a progressive lung disease with poor prognosis, the subcutaneous form is usually not a cause of serious concern. It doesn't always cause pain or other distressing symptoms. However, the conditions that give rise to this condition are often quite serious. For instance, pneumothorax is a very serious condition that causes symptoms such as chest pain, low blood pressure, and shortness of breath. If a lot of air gets accumulated in the pleural space, it may even lead to cardiovascular dysfunction. Swelling of the neck or face, and crackling sensation on touching the affected skin are the most common symptoms. In severe cases, one may experience chest pain, neck pain, wheezing, difficulty in swallowing, or breathing problems.
If the affected individual is having trouble breathing, then small incisions might be made to release the trapped air. If the air is trapped in the chest region, then catheters or chest tubes might be placed for removing the air. Treating the underlying disease can help in alleviating the symptoms to a great extent. Doctors often follow a symptomatic approach for the treatment of this condition. For instance, shortness of breath can be treated by providing supplemental oxygen. Painkillers or anti-inflammatory drugs are usually prescribed for pain relief. In case of traumatic injuries to the trachea, esophagus, or the bronchial tubes, the recovery would depend on the extent of damage. Generally, corrective surgery and drug therapy would be required for treating such injuries. It's therefore essential that a thorough medical checkup be performed, if one sustains such a traumatic injury.
Though subcutaneous emphysema is not a life-threatening disease in itself, the underlying conditions that may give rise to it are usually grave in nature. If left unresolved, such conditions may have serious repercussions on one's health. Therefore, it is important that one consults a doctor on experiencing the aforementioned symptoms. While you are recovering from this condition, make sure that you refrain from any activity that can cause stress on the respiratory organs.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.