Subcutaneous Emphysema

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Subcutaneous emphysema

Content:

• Causes of subcutaneous emphysema
• Symptoms of subcutaneous emphysema
• Treatment of subcutaneous emphysema

What is subcutaneous emphysema?

Subcutaneous emphysema is the accumulation of gas or air bubbles in tissues that cause an air cushion to form. Literally, the term emphysema can be translated as increased airiness. The cause of this disease can be a chest injury, as a result of which the respiratory organs were significantly injured, as well as as a result of damage to the esophagus. That is why the air entering the mediastinum squeezes large arteries and vessels, which leads to asphyxia, cardiovascular failure and, as a result, death.

The cause of subcutaneous emphysema can also be an external deep wound, during the application of which the respiratory organs were damaged.

In medicine, it is customary to distinguish between several main sources of air ingress into tissues, namely, only three:

• a chest wound, which only has the property of allowing air to pass through the tissue, but not allowing it to come out;
• with damage to the bronchi, trachea or esophagus, when the mediastinal pleura is damaged, thus air from the mediastinum freely penetrates into the pleural cavity;
• simultaneous violation of the integrity of the parietal pleura and lung, the wound has a valve-like appearance.

When air enters the tissues, it can freely move under the skin from the areola area to the face area. Subcutaneous emphysema most often does not cause any disturbances perceptible to patients. In itself, this disease is not dangerous if the cause of its occurrence is identified in time. To find the cause, it is important to follow the dynamics of the development of this process.

Doctors divide all patients into two age categories: young and those who are over 40 years old. The disease in such people always proceeds in different ways. In young people, around the age of 20-30, emphysema proceeds in a much milder form and practically without consequences. In older people, over 40 years of age, the disease is much more severe and recovery from the disease takes a little longer.

Causes of subcutaneous emphysema

Doctors identify the following reasons as a result of which subcutaneous emphysema appears:

• Chronic bronchitis, smoking. In 90% of cases, it is smoking that causes the development of emphysema. Many patients are mistaken, believing that smoker's bronchitis is a completely harmless disease. Tobacco smoke contains a large amount of harmful substances that cause destruction of the airways in the smoker's body. This leads to difficult changes;
• Change in the normal shape of the chest as a result of external influences, trauma;
• Serious trauma (closed rib fracture, a fragment of which pierced the lung) or breast surgery, laproscopy;
• Anomaly in the development of the respiratory system, most often these are congenital defects;
• Inhalation of toxic substances that have a destructive effect on the respiratory system (professional activity, polluted environment, work with toxic substances or in hazardous industries, builders, etc., people who breathe air containing many harmful impurities);
• A gunshot wound, almost point-blank. Due to the effect of powder gases on the skin around the wound, non-extensive emphysema occurs;
• Anaerobic infection;
• Knife, blunt wounds;
• Car accidents, during which victims are struck with tremendous force by the chest against the steering wheel or seats;
• Lung damage caused by very strong internal pressure, the so-called barotrauma (jumping into water, sudden diving);
• With a fracture of the facial bones;
• Neoplasms in the neck and trachea;
• Angina Ludwig;
• Perforation of the esophagus. This is the rarest reason;
• Sometimes emphysema occurs during dental surgery, due to the peculiarities of the instrument;
• Large joint injury (knee joint);
• With artificial ventilation. Using a tracheal tube.

Symptoms of subcutaneous emphysema

Often the symptoms of subcutaneous emphysema are:

• swelling in the neck;
• chest pain when breathing;
• sore throat, difficulty swallowing;
• labored breathing;
• swelling of the skin in the absence of obvious traces of its inflammatory process.

It is possible to detect subcutaneous emphysema using X-rays in the last stages of the disease. And also by simple palpation in the alleged area of air accumulation. The presence of air bubbles under the skin will be felt very well under the fingers.

When palpating, the patient will not feel any pain or discomfort. When you press on the area of accumulation of gases, a characteristic sound is heard, which is very reminiscent of the crunching of snow. With a significant accumulation of air under the skin, the tissues adjacent to this area swell so much that it becomes noticeable to the naked eye.

If subcutaneous emphysema develops in the neck, the patient's voice may change, making it difficult to breathe.

Air can accumulate under the skin in various parts of the body, even on the legs and arms, and the abdomen.

Treatment of subcutaneous emphysema

Emphysema can be diagnosed with x-rays or computed tomography of the chest. As soon as air bubbles are noticed in the tissues of the body, treatment begins immediately. In the early stages of the disease, conservative therapy is carried out, that is, special sprays and aerosols are prescribed. However, they are in no way able to stop the development of the disease.

The course of the disease is carefully monitored by doctors at regular intervals, and exacerbations of the disease are noted 2 or 3 times a year. During such exacerbations, severe shortness of breath develops. In the third and fourth stages of emphysema, therapeutic treatment has no effect on the disease and the patient has to agree to surgical intervention.

Although in fact, subcutaneous emphysema most often does not require any treatment. By itself, this disease does not pose any danger to the human body, it is only a consequence of an external injury or any internal organ. And after that it is eliminated. The air injection under the skin stops. The disease gradually disappears without specialized medication.

How effectively the cause of emphysema was eliminated is indicated by air resorption. To speed up the healing process, breathing exercises in the fresh country air are recommended. At the same time, the blood is saturated with oxygen, which helps to wash out nitrogen from the body.

Depending on the size of emphysema, a certain surgical procedure is performed, which is aimed at eliminating the accumulation of air as much as possible.

Emphysema can be dangerous only if it is formed in the chest area and rapidly spreads to the neck, initially under the skin, and then already penetrates the tissues of the neck and mediastinum, which may well cause compression of internal vital organs. In this case, an urgent operation is required, which will help to identify the cause of the air injection, as well as eliminate it without serious consequences for the patient.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".