Surgical emphysema, also widely known as subcutaneous emphysema, is defined as a clinical state in which air gets trapped subcutaneously. The etiology may be traumatic or atraumatic, and multiple causes in each are present. Case report. A 63-year-old female patient presented to the emergency room with a facial soft tissue injury following road traffic accident and developed surgical emphysema later on with no evidence of rib fractures or pneumothorax. Infectious etiology was ruled out. Due to the respiratory embarrassment, the patient was electively intubated. Conservative management was provided. Emphysema resolved within 24 hours after the accident. Discussion. Various theories have been outlined in literature, like Mackler effect, Crampton theory and ballvalve mechanism. In our case, it was difficult to apply any of these theories to confirm the diagnosis. Conservative management is still used in the treatment of surgical emphysema. Conclusion. Surgical emphysema is a common encounter in trauma practice, and its identification is essential to rule out any emergency causes which may lead to respiratory distress.

Background: The incidence of self-inflicted anger related upper extremity injuries due to punching glass, involving dominant hand has increased in recent years even in our rural population of less than 1.5 million in District of Kolar, Karnataka, India. Although hospital stay is short, these patients require long term follow up, physiotherapy and occupational rehabilitation.Methods: This study is a case series involving a a retrospective analysis from June 1, 2015, to July 31, 2017.  Our study involved only glass cut injury following an angry intention.Results: This study included 9 eligible patients who were all young male aged between 18 to 28 years (median age: 23.4 years) who had triggering factor before punching the glass pane. All patients had tendon injuries, flexors (n=4), extensor (n=3), both (n=2), muscle injuries (n=1), median nerve (n=2), radial artery (n=3). All injuries required operative intervention. Mean hospital stay was 5.2 days. Mean rehabilitation period was 5.2 months.Conclusions: These types of injuries can be prevented by regular counseling for stress/anger management as a part of rehabilitation to prevent further recurrences.