Subcutaneous emphysema

Introduction The subcutaneous tissue of the chest has subcutaneous emphysema in the presence of gas volume. Pressing the subcutaneous emphysema on the skin can cause the gas to move in the subcutaneous tissue, which may cause a burst or a sense of snow. Subcutaneous emphysema When a subcutaneous emphysema is pressed with a stethoscope, a sound similar to swaying hair can be heard. Subcutaneous emphysema in the chest is caused by damage to the lungs, trachea or pleura, and the gas escapes from the lesion and accumulates under the skin. Occasionally, it occurs in a local gas-producing bacillus infection. Severe gas can spread from the chest wall down to the neck, abdomen or other parts of the skin.

Cause

(1) Causes of the disease

Subcutaneous emphysema of the chest wall is generally secondary to sternum and/or rib fracture with pneumothorax, especially in patients with multiple rib fractures with tension pneumothorax, but also in tracheal, bronchial, pulmonary and esophageal injuries. Occasionally secondary to endoscopic examination of the injury.

(two) pathogenesis

Closed and open injuries to the chest are often accompanied by subcutaneous gas accumulation. There are usually three ways in which air can enter the subcutaneous tissue through the damaged site:

1 When the pneumothorax is accompanied by damage to the parietal pleura, the air in the thoracic cavity can enter the subcutaneous tissue of the chest wall through the damaged part.

2 When the trachea, bronchus or esophagus ruptures, the air can enter the mediastinum directly from the rupture port, and then spread through the sternum to the subcutaneous tissue of the neck, face and chest.

3 Air directly enters the subcutaneous tissue through the chest wall surface wound.

an examination

Related inspection

Chest CT chest CT examination

In general, patients with subcutaneous emphysema have no symptoms, but the effect of a pair of patients is difficult to blink. Patients with mediastinal emphysema often complain of chest tightness or post-sternal pain, and may also have hoarseness. The subcutaneous tissue is swollen, with a sponge-like feel and a squeaky sound and a sense of snow. If the smell of rough snoring occurs with the heartbeat, it is seen when the mediastinal emphysema. Severe mediastinal emphysema can affect venous return, manifestations of jugular vein dilatation, tachycardia, dyspnea, and even heart failure.

After the chest injury, the skin on the chest wall is swollen. If you touch the sponge and the sputum sound with your fingers, it indicates subcutaneous emphysema. It is generally not easy to miss or misdiagnose. Careful clinical observations help to clarify the source of emphysema. If the emphysema is first manifested in the neck, it should be considered that the source may be mediastinal emphysema. The site where emphysema first appears on the chest wall is often the site of rib fracture. X-ray examination helps to further identify the source of emphysema.

Differential diagnosis

In general, patients with subcutaneous emphysema have no symptoms, but the effect of a pair of patients is difficult to blink. Patients with mediastinal emphysema often complain of chest tightness or post-sternal pain, and may also have hoarseness. The subcutaneous tissue is swollen, with a sponge-like feel and a squeaky sound and a sense of snow. If the smell of rough snoring occurs with the heartbeat, it is seen when the mediastinal emphysema. Severe mediastinal emphysema can affect venous return, manifestations of jugular vein dilatation, tachycardia, dyspnea, and even heart failure.

After the chest injury, the skin on the chest wall is swollen. If you touch the sponge and the sputum sound with your fingers, it indicates subcutaneous emphysema. It is generally not easy to miss or misdiagnose. Careful clinical observations help to clarify the source of emphysema. If the emphysema is first manifested in the neck, it should be considered that the source may be mediastinal emphysema. The site where emphysema first appears on the chest wall is often the site of rib fracture. X-ray examination helps to further identify the source of emphysema.

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