Massive subcutaneous emphysema after traumatic pneumothorax

Abstract

A simple case/asymptomatic pneumothorax not deemed to necessitate drainage can quickly change, and patient safety can be compromised. Chest tube insertion with increased suction is considered a safe and efficient strategy in patients with extensive subcutaneous emphysema following traumatic pneumothorax.

Periorbital Emphysema Due to Traumatic Pneumothorax

“…In the differential diagnosis of periorbital edema, in addition to allergic, inflammatory, and systemic causes, the traumatic ones and iatrogenesis associated with invasive procedures should not be excluded [8][9][10][11][12]. In this case, there was no evidence of spontaneous bronchopleural fistulas or iatrogenic placement of the chest tube, since it was placed after the PE had already formed [7,10,12].…”

“…By an identical mechanism, with a reverse circuit, after facial trauma the air can invade the neck spaces, creating subcutaneous emphysema with evolution to pneumomediastinum and pneumothorax [8]. PE is clinically classified into four stages as follows: stage I -no clinical signs, only radiological; stage IIdystopia/proptosis of the globe; stage III -loss of vision due to compression of the optic nerve; and stage IV -occlusion of the central retinal artery [11][12][13][14].…”

A Case of Tension Subcutaneous Emphysema Treated With Minimally Invasive Open-Window Thoracostomy Using a Wound Protector/Retractor and Three-Sided Taping

“…When air leakage is extensive, which may occur in patients with emphysema or a bronchial stump fistula, conventional drainage methods may fail to prevent the progression of subcutaneous emphysema, which can cause tension subcutaneous emphysema with compromise of ventilation. In previous reports, subcutaneous emphysema has been treated using chest tubes [5], subcutaneous drains [6], and re-operation [1]. However, in an emergency situation, a rapid and simple bedside procedure is essential.…”