Progressive subcutaneous emphysema of unknown origin: a surgical dilemma

Roeck, Lynn De; Assche, Lauranne Van; Verhoeven, Véronique; Vrints, Ina; Thielen, Jana Van; Tondu, Thierry; Thiessen, Filip

doi:10.1080/00015458.2018.1438560

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…However, the air in the soft tissue of the chest may obscure critically serious conditions such as pneumothorax [ 8 ]. Additional imaging as CT scan of the affected area is essential in patients who are stable [ 8 , 16 ]. It is rarely reported in the literature that subcutaneous emphysema has been mistaken with angioedema due to similarity in manifestation such as difficulty in breathing and fascial swelling [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Management of post lobectomy subcutaneous emphysema; a case report with literature review

Ali¹,

Kakamad

Abdalla³

et al. 2021

Annals of Medicine &Amp; Surgery

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Introduction Subcutaneous emphysema is an extremely rare complication after lobectomy. The current study aims to report a case of lung cancer developing extensive subcutaneous emphysema after lobectomy. Case presentation A 73-year-old man presented with dyspnea and cough for one month duration associated with wheeze and sputum. He was a chronic heavy smoker (100 pack/year). Work up revealed squamous cell carcinoma. Although he had poor pulmonary function tests, he underwent left upper lobectomy. On the fifth postoperative day, he was discharged from the hospital as there was no air leak and the lung remained expanded 15 hours after clamping of the thoracostomy tube. Two days later, the patient developed generalized subcutaneous emphysema. The patient was re-admitted to the hospital and a thoracostomy tube was inserted. The lung expanded upon insertion while the subcutaneous emphysema remained the same and even slightly increased over night. A 3 cm incision was made at the left infra-clavicular area and a negative pressure applied to it. The subcutaneous emphysema completely subsided a few hours after this intervention. Discussion Because of the benign course, the majority of cases of subcutaneous emphysema (mild to moderate) only need nonoperative management alongside treatment of the predisposing factors. These patients may need nothing other than bed rest, good analgesia, supplemental oxygen, and reassurance. Conclusion Subcutaneous emphysema after lobectomy prolongs hospital stay. It mainly occurs in cases with poor pulmonary function tests, steroid use, and those with extensive adhesion.

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Section: Discussionmentioning

confidence: 99%

Management of post lobectomy subcutaneous emphysema; a case report with literature review

Ali¹,

Kakamad

Abdalla³

et al. 2021

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

show abstract

“…In addition, some case reports on an SE after a minor skin lesion can be found in the literature [10][11][12][13][14][15][16]. Diagnosis and management of these so-called benign subcutaneous emphysema (BSCE) can be challenging [17,18]. While the misdiagnosis of an NSTI in non-infectious SE may lead to an unnecessary and aggressive surgical treatment, the failure to identify a necrotizing infection usually results in limb amputation or even death.…”

Section: Introductionmentioning

confidence: 99%