In this article, we will discuss causes and treatment of subcutaneous emphysema in a detailed account.
What is subcutaneous emphysema?
Subcutaneous refers to the tissue below the skin, whereas emphysema refers to build up of air. Hence, whenever air is or builds up inside your tissue beneath the skin, we call is subcutaneous emphysema.
This medical condition is also known as Hamman’s syndrome or Macklin’s syndrome by some people. It is because; Dr.Hamman and Macklin contributed a lot to understand the pathophysiology of this disease.
Subcutaneous emphysema cause, and treatment:
Subcutaneous emphysema basically is a lung disease, but, here we shall talk about subcutaneous emphysema. There are many causes of subcutaneous emphysema-like rupture of oesophagus or lungs tissue.
These are the sites the air travel from and reach to the skin tissues. The symptoms of this condition are coughing, wheezing etc.
Subcutaneous emphysema treatment includes surgical removal of air from the tissue and administration of medications. To more the things in detail, go through the following article.
Main Causes of subcutaneous emphysema
The primary cause of subcutaneous emphysema is injury or trauma.
As we know, whenever we breathe, air goes into the lungs. The air is then circulated all over the body. But, due to trauma or injury, the tissue of the airway, lungs or digestive tract ruptures.
The ruptured tissue leaks air into surrounding tissues and eventually air travel to the tissue beneath the skin. Here it gets accumulated as an air bubble or air sac. Therefore, the major sites for subcutaneous emphysema are proximal to the lungs such as chest, face, and neck.
Let us look into some of the causes of subcutaneous emphysema.
Chest trauma: Whenever you experience and trauma at your chest region, there are chances that will have emphysema on the chest wall.
During any car accident, collision or when something sharp penetrates your chest, alveoli of your ling ruptures. Such injury to the alveoli is very much similar to the pulmonary laceration.
The pulmonary laceration is any sort of injury or cuts in the lung tissue.
Formation of gas gangrene: Gas gangrene is also an important cause of subcutaneous emphysema. Gas gangrene is the local accumulation of gas. It happens due to due to bacterial infection. Bacteria Clostridium plays a major role in the formation of gas in case of gas gangrene.
Surgery: Any surgical procedure of the thorax such endoscopy or bronchoscopy can rupture the air passage or lungs tissue.
Further, it can result in subcutaneous emphysema. If any of this surgical procedure causes you emphysema, we call it surgical emphysema. Sometimes injury by pneumatic tools can cause emphysema in limbs such as legs, hands, etc.
Unknown reason: Sometimes, the real cause of emphysema is not clear. Therefore, we call spontaneous subcutaneous emphysema to such conditions. Spontaneous subcutaneous emphysema treatment is not that easy because we don’t know the cause.
Treatment of Subcutaneous emphysema:
Subcutaneous emphysema treatment is not required if the underlying condition is cured. However, the amount of trapped air is so much that it hinders breathing a lot and feel uncomfortable.
Surgery:
Surgery of subcutaneous emphysema is sometimes required as a treatment.
Sometime, subcutaneous may lead to more severe massive subcutaneous emphysema. This condition requires urgent medical intervention and the deposited air is removed by surgical drainage.
Positive pressure ventilation sometimes drains excessive air to the facial subcutaneous tissue. So, the patient may have visual disturbances due to the swelling eyelids.
Moreover, it may hinder the flow of air to the extremities and vital organs such as scrotum, labia, and breast leading the necrosis of tissue. In such cases, treatment is required with adequate decompression. Otherwise, extreme pressure on the trachea can build up.
Whenever pneumothorax causes subcutaneous emphysema, the doctor inserts a chest tube into the chest. This is usually done by cutting the skin tissue. The chest tube continuously removes the trapped air. Sometimes, the doctor may do suction of the chest tube to promote the quick release of air.
Catheters are usually placed for the surgical removal of air from the subcutaneous tissue.
We can treat the underlying condition, but sometimes we don’t know the reason causing it in the case of spontaneous subcutaneous emphysema. In such cases, the patient needs to take rest and take painkillers to manage pain.
Oxygen supplements can aid in the reabsorption of some subcutaneous air by the body.
Sometimes, the lung transplant is required in severe cases.