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Subcutaneous emphysema is the presence of air or gas in skin tissue caused by lung or airway damage. It is not usually painful but can cause swelling and crackling sounds. The underlying cause is the primary concern, and treatment may include surgery or chest tubes.
Subcutaneous emphysema refers to the presence of air or gas within the layers of skin tissue. The condition usually occurs when air escapes from the lungs or airways through a tear or sting. A person may notice swelling in the neck and chest and palpable bubbles that make a crackling sound when pressed. In most cases, subcutaneous emphysema itself is not painful or causes any major complications. The underlying cause is usually the primary concern for doctors, and treating it quickly is necessary to prevent serious heart or breathing problems.
Many different diseases and injuries can cause subcutaneous emphysema. Many cases are caused by trauma to the chest or neck. A gunshot, knife wound, or blunt force from a fall or car accident can damage your lungs or windpipe. Serious lung infections, chronic diseases, and cancers can weaken the linings of lung tissue and lead to lung collapse. Occasionally, botched surgery or an improperly placed chest tube can also cause air to leak into the chest cavity.
Subcutaneous emphysema caused by blunt or penetrating trauma is usually not the primary concern of healthcare professionals. The condition may not be noticed or addressed until life-saving steps have been taken to stop the bleeding or re-inflate a damaged lung. After a patient is stable, doctors can look for signs of emphysema.
The most common symptoms include slight swelling, pain in the chest and neck, and difficulty breathing. The popping blisters can usually be felt, moved and crushed under the skin. Chest X-rays and computed tomography may be done to determine the amount and exact location of the air sacs.
Most cases of subcutaneous emphysema do not need to be treated directly. Air bubbles tend to dissipate on their own within a few hours, provided the lung and airway problems have already been corrected. If a small amount of air persists, a doctor may choose to make several small, deep incisions in the skin to allow the gas to escape. Catheters can be used to aspirate large amounts of air from the chest cavity and surrounding skin tissue.
You may need additional treatment if there is enough air remaining to put excessive pressure on your windpipe or lungs. A chest tube can be inserted to suction the chest cavity. A patient may need to wear an oxygen mask or be given a breathing tube while subsequent repairs to the lungs and airways are made.
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