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Subcutis Emphysema, Causes, Diagnosis, Treatment, Prevention, Complications

Subcutaneous emphysema is a condition where air or gas is trapped under the skin layer. This condition is often caused by injury to the respiratory tract from an accident, stab wound, surgical complications, or infection. Subcutaneous emphysema is a dangerous condition that needs to be treated immediately because it puts pressure on organs. Pressure on an organ can result in tissue death and shrinkage of the lungs. 

Subcutis Emphysema, Causes, Diagnosis, Treatment, Prevention, Complications
Subcutis Emphysema, Causes, Diagnosis, Treatment, Prevention, Complications

Causes of Subcutaneous Emphysema

The bottom layer of the skin (subcutaneous tissue) functions to protect internal organs and acts as a fat storage area. Subcutaneous emphysema can occur when air, both from outside and from the lungs and digestive tract, enters and is trapped in the subcutaneous layer.

Subcutaneous emphysema can be caused by a variety of the following conditions or diseases:

  • Severe injuries, such as facial or chest fractures, stab wounds, and gunshot wounds
  • Pneumothorax, which can result from an injury to the sternum
  • Tears in the respiratory tract, esophagus (oesophagus), or digestive tract
  • Severe bacterial infection that can spread quickly and damage skin tissue
  • Complications of medical procedures, such as endoscopy, laparoscopy, bronchoscopy, and endotracheal intubation
  • Barotrauma, namely injuries due to sudden changes in air pressure, for example in divers

Risk factors for subcutaneous emphysema

There are several factors that can increase a person's risk of experiencing subcutaneous emphysema, namely:

  • Got an accident
  • Have certain medical conditions, such as whooping cough
  • Abusing drugs, especially cocaine
  • Swallowing a chemical that can damage the esophagus

Subcutaneous Emphysema Symptoms

Symptoms of subcutaneous emphysema can be mild to severe, depending on the cause. The main symptoms are swelling and a popping sound when pressure is applied to the affected area.

Patients with subcutaneous emphysema can experience other symptoms, such as:

  • Hard to breathe
  • Difficult and painful swallowing
  • Voice change
  • Swollen eyelids, neck or stomach
  • The chest looks asymmetrical

Although it can affect any part of the body, subcutaneous emphysema generally occurs on the chest, neck or face.

When to see a doctor

Patients with subcutaneous emphysema must quickly get medical help. Seek medical help immediately if you or those around you experience symptoms of subcutaneous emphysema, especially if there are the risk factors above.

Keep in mind, don't prick or press on the swollen part. Also, do not give food and drink to people suspected of having subcutaneous emphysema in the face, chest and stomach area. Remain near the person until medical personnel arrive to provide assistance.

Diagnosis of subcutaneous emphysema

The doctor will conduct questions and answers regarding the patient's symptoms and medical history. After that, the doctor will carry out a physical examination by pressing the swollen body parts and finding out if you hear a crackling sound. To confirm the diagnosis, the doctor may run the following tests:

  • Chest X-rays, to detect trapped air in the chest and abdominal cavities
  • CT scan, to detect air in the chest or digestive tract, as well as diagnose digestive tract leaks
  • Ultrasound, to detect subcutaneous emphysema due to pneumothorax
  • Laryngoscopy or bronchoscopy, to detect subcutaneous emphysema due to the procedure of placing a breathing apparatus

Subcutaneous Emphysema Treatment

Treatment for subcutaneous emphysema aims to relieve symptoms, ensure the body gets enough oxygen, and remove air trapped under the skin. Some of the methods that doctors can do are:

  • Administration of high doses of oxygen, to help the body absorb air under the skin
  • Inserting a tube under the collarbone to treat subcutaneous emphysema in the chest
  • Installation of a tube on the ribs, to release air that suppresses the lungs so that the patient's breathing becomes smooth

In some cases, the doctor will perform a small operation by incising the area of the skin affected by subcutaneous emphysema. Through the incision, the doctor will insert a small tube to remove air.

Complications of Subcutaneous Emphysema

Untreated subcutaneous emphysema in the chest area can compress the lungs until they collapse. As a result, patients can experience hypoxia, lack of oxygen, to sudden cardiac arrest.

If it occurs in the layers of the skin on other areas of the body, subcutaneous emphysema can cause compartment syndrome. In this condition, blood flow to the organs below can be suppressed so that the organs experience tissue death (gangrene).

Apart from some of the conditions above, lack of oxygen can also cause damage to the brain and skin.

Subcutaneous Emphysema Prevention

Subcutaneous emphysema can't always be prevented. However, the risk of this condition occurring can be avoided with the following efforts:

  • Be careful and always use personal protective equipment when driving, working or playing sports
  • See a doctor immediately if you have a severe cough
  • Ensuring children get complete immunizations to avoid whooping cough
  • Wash your hands regularly to prevent disease

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