Subcutaneous emphysema

Case contributed by Franco A. Scola
Diagnosis certain

Presentation

Pleural drainage control.

Patient Data

Age: 65 years
Gender: Female
ct

Left hydropneumothorax, causing complete atelectasis of the left lower lobe and partial collapse of the ipsilateral superior lobe. 

Subcutaneous emphysema dissecting into the deeper soft tissue and musculature, extending to the upper mediastinum.

Right small pleural effusion.

Extensive emphysematous areas and bullae in both lungs.

Small areas which are partially spared from emphysema in the middle and lower right lobe.

Left thoracic drain.

Previous pleural drainage attempt formed a continuity between the pleural space and the subcutaneous tissues on the lateral aspect of the left upper thoracic region.

Orotracheal tube with distal end in right main bronchus.

Case Discussion

This case shows a very severe example of one of the complications of pleural drainage, subcutaneous emphysema. There is also pneumomediastinum.

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