In cases of subcutaneous emphysema around the neck, there may be a feeling of fullness in the neck, and the sound of the voice may change.
If large amounts of air leak into the tissues around the head, the face can swell considerably. The tissues surrounding SCE are usually swollen. The air bubbles, which are painless and feel like small nodules to the touch, may burst when the skin above them is palpated.
Touching the bubbles causes them to move and sometimes make a crackling noise. A significant case of subcutaneous emphysema can be detected by touching the overlying skin, which will feel like tissue paper or Rice Krispies. Chest X-rays may show air in the mediastinum, the middle of the chest cavity. Signs and symptoms of spontaneous subcutaneous emphysema vary based on the cause, but it is often associated with swelling of the neck and chest pain, and may also involve sore throat, neck pain, difficulty swallowing, wheezing and difficulty breathing. However, subcutaneous emphysema can be uncomfortable and may interfere with breathing, and is often treated by removing air from the tissues, for example by using large bore needles, skin incisions or subcutaneous catheterization. Although the underlying conditions require treatment, subcutaneous emphysema usually does not small amounts of air are reabsorbed by the body. Subcutaneous emphysema is not typically dangerous in and of itself, however it can be a symptom of very dangerous underlying conditions, such as pneumothorax. The term spontaneous subcutaneous emphysema is used when the cause is not clear. When the condition is caused by surgery it is called surgical emphysema. It can also occur spontaneously due to rupture of the alveoli, with dramatic presentation. Its most common causes are pneumothorax or a chest tube that has become occluded by a blood clot or fibrinous material. Subcutaneous emphysema can be caused by medical procedures and medical conditions that cause the pressure in the alveoli of the lung to be higher than that in the tissues outside of them. Infection (e.g., gas gangrene) can cause gas to be trapped in the subcutaneous tissues. Particularly in the chest and neck, air may become trapped as a result of penetrating trauma (e.g., gunshot wounds or stab wounds) or blunt trauma. Subcutaneous emphysema can result from puncture of parts of the respiratory or gastrointestinal systems. Macklin, in 1944, who cumulatively went on to describe the pathophysiology in more detail. However, in some medical circles, it can instead be more commonly known as Macklin's Syndrome after L. Louis Hamman described it in postpartum woman indeed, subcutaneous emphysema is sometimes known as Hamman's syndrome. Later, in 1939, at Johns Hopkins Hospital, Dr. Pneumomediastinum was first recognized as a medical entity by Laennec, who reported it as a consequence of trauma in 1819. Numerous etiologies of subcutaneous emphysema have been described. This sensation of air under the skin is known as subcutaneous crepitation, a form of crepitus. Subcutaneous emphysema has a characteristic crackling-feel to the touch, a sensation that has been described as similar to touching warm Rice Krispies.
Since the air generally comes from the chest cavity, subcutaneous emphysema usually occurs around the upper torso, such as on the chest, neck, face, axillae and arms, where it is able to travel with little resistance along the loose connective tissue within the superficial fascia. Subcutaneous refers to the subcutaneous tissue, and emphysema refers to trapped air pockets. Subcutaneous emphysema ( SCE, SE) occurs when gas or air accumulates and seeps under the skin, where normally no gas should be present. Surgical emphysema, tissue emphysema, sub Q airĪn abdominal CT scan of a patient with subcutaneous emphysema (arrows)