Subcutaneous emphysema mimicking angioedema

Dhawan, Amit; Singal, Archana; Bisherwal, Kavita; Pandhi, Deepika

doi:10.4103/2229-5178.174304

Cited by 12 publications

(21 citation statements)

References 7 publications

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“…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 ]. However, one can differentiate between the two because emphysema spares the lips and crepitus on palpation is specific for subcutaneous emphysema [ 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

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show abstract

“…Subcutaneous emphysema is a rare disease with the sudden onset of swelling as a result of air entrapment under the skin [24][25][26][27]. There are various causes including blunt or penetrating trauma to the chest or neck, following gastrointestinal perforation (corrosive burns of the esophagus, Boerhaave's syndrome, gas gangrene), diving injuries, endoscopy, tracheostomy, cryosurgery, dental surgery or skin biopsy [24].…”

Section: Subcutaneous Emphysemamentioning

confidence: 99%

Section: Subcutaneous Emphysemamentioning

confidence: 99%

“…There are various causes including blunt or penetrating trauma to the chest or neck, following gastrointestinal perforation (corrosive burns of the esophagus, Boerhaave's syndrome, gas gangrene), diving injuries, endoscopy, tracheostomy, cryosurgery, dental surgery or skin biopsy [24]. The majority of the cases which mimic angioedema is reported after a dental surgery [24,27]. The main clinical clue for differentiation from angioedema is a characteristic crackling sensation created as the gas is pushed through the tissue during palpation which is called crepitus [4,24,26].…”

Section: Subcutaneous Emphysemamentioning

confidence: 99%

“…The majority of the cases which mimic angioedema is reported after a dental surgery [24,27]. The main clinical clue for differentiation from angioedema is a characteristic crackling sensation created as the gas is pushed through the tissue during palpation which is called crepitus [4,24,26]. In doubtful cases, an X-ray or a CT scan could be performed [25].…”

Section: Subcutaneous Emphysemamentioning

confidence: 99%

See 2 more Smart Citations

Pseudoangioedema

Akarsu¹,

Canturk²

2017

A Comprehensive Review of Urticaria and Angioedema

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Angioedema is a rapid, localized and temporary subcutaneous edema, which targets the lips, eyelids, gastrointestinal and respiratory mucosa resulting in abdominal pain, asthma and even serious life-threatening conditions like airway obstruction. There are several other disorders such as allergic contact dermatitis, drug rash with eosinophilia and systemic symptoms (DRESS), superior vena cava syndrome (SVCS), orofacial granulomatosis and so on, which manifest with subcutaneous swelling and masquerade as angioedema and are known as 'pseudoangioedema' in the literature. Knowledge of pseudoangioedema for healthcare professionals is crucial to avoid potentially serious results of misdiagnosis such as further investigations, unnecessary applications and delayed diagnosis. We aim to discuss differential diagnosis of angioedema and help physicians recognize the typical features of angioedema and its differential diagnosis in this chapter.

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Could it be hereditary angioedema?—Perspectives from different medical specialties

Magerl,

Sala‐Cunill,

Weber‐Chrysochoou

et al. 2023

Clinical & Translational All

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Hereditary angioedema (HAE) is a rare autosomal dominant disease, with patients often suffering with associated symptoms for many years before receiving a correct diagnosis. The symptoms greatly impact a patient's quality of life (QoL) and include excruciating abdominal pain and angioedema of the skin and submucosa. Angioedema of the larynx represents a significant mortality risk in undiagnosed patients, and a large proportion of patients with HAE receive incorrect diagnoses and undergo unnecessary surgery. HAE‐specific treatments can control and prevent acute life‐threatening episodes, in addition to improving QoL, emphasizing the value of early diagnosis for patients. Diagnostic delay may be due to a lack of HAE awareness by healthcare professionals and the similarity of HAE symptoms with those of more common conditions, complicating differential diagnosis. The multifaceted nature of the condition may result in visits to one of many different medical settings, for example: the Emergency Room, pediatrics, general practice, otolaryngology, gastroenterology, and dermatology. Therefore, it is crucial that physicians in multiple healthcare specialties are aware of the disease to ensure that patients with HAE receive a timely diagnosis. Using patient cases from various medical specialties, this review highlights the necessity for cross‐specialty awareness of HAE and outlines the essential information for the various healthcare professionals that may encounter a patient with HAE symptoms, in order to effectively treat and/or diagnose HAE.

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Subcutaneous emphysema mimicking angioedema

Cited by 12 publications

References 7 publications

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

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

Pseudoangioedema

Could it be hereditary angioedema?—Perspectives from different medical specialties

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