Surgical emphysema (summary)

Changed by Jeremy Jones, 21 Jun 2017

Updates to Article Attributes

Body was changed:

Show markup changes

Surgical emphysema (or subcutaneous emphysema) occurs when air/gas is located in the subcutaneous tissues (the layer under the skin). This usually occurs in the chest, face or neck.

Reference article

This is a summary article; read more in our article on surgical emphysema.

Summary

pathophysiology
- gas within the soft tissues
- causes
  - tracheobronchial perforation with gas tracking
  - penetrating trauma
~~investigation~~radiographic features
- chest x-ray
  - gas within the soft tissues
  - ~~can be~~ easy to see in the neck and upper chest
  - ~~can~~may have a ~~very~~ strange appearance with overlying structures
- CT chest
  - much more readily demonstrated on a CT

Radiographic features

Plain radiograph

~~Radiolucent striations may be seen outlining~~ ~~pectoralis major, especially if the surgical emphysema is located in the anterior chest wall (sometimes called the~~ ~~ginkgo leaf sign). This is due to the air surrounding the muscle fibre bundles.~~

CT chest

~~Pockets~~

pockets of air located seen as dark areas located in the subcutaneous space of ~~area~~the affected. tissues

~~-<strong>investigation</strong><ul>~~
+<strong>radiographic features</strong><ul>
~~-<li>can be easy to see in the neck and upper chest</li>~~
~~-<li>can have a very strange appearance with overlying structures</li>~~
+<li>easy to see in the neck and upper chest</li>
+<li>may have a strange appearance with overlying structures</li>
~~-<li>CT chest<ul><li>much more readily demonstrated on a CT</li></ul>~~
+<li>
+<a href="/articles/ct-chest-summary">CT chest</a><ul>
+<li>much more readily demonstrated on a CT</li>
+<li>pockets of air located seen as dark areas located in the subcutaneous space of the affected tissues</li>
+</ul>
-</ul><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>Radiolucent striations may be seen outlining <a href="/articles/pectoralis-major-1">pectoralis major</a>, especially if the surgical emphysema is located in the anterior chest wall (sometimes called the <a href="/articles/ginkgo-leaf-sign-chest">ginkgo leaf sign</a>). This is due to the air surrounding the muscle fibre bundles.</p><h5>CT chest</h5><p>Pockets of air located seen as dark areas located in the subcutaneous space of area affected.</p>
+</ul>