Surgical emphysema (summary)

Changed by Derek Smith, 9 Jan 2018

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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

Imaging

role of imaging
- is there surgical emphysema?
- ~~what~~where is it~~'s distribution~~ distributed?
- is there other free gas? e.g. pneumomediastinum
- what's the cause? e.g. hyperinflation in asthma
radiographic features
- chest x-ray
  - gas within the soft tissues
  - easy to see in the neck and upper chest
  - may have a strange appearance with overlying structures
- CT chest
  - much more readily demonstrated on a CT
  - pockets of air seen as dark areas located in the subcutaneous tissues