Subcutaneous emphysema overview: Difference between revisions
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==Overview== | ==Overview== | ||
'''Subcutaneous emphysema''', sometimes abbreviated '''SCE''' or '''SE''' and also called '''tissue emphysema''', occurs when gas or air is present in the [[subcutaneous tissue|subcutaneous]] layer of the skin. ''Subcutaneous'' refers to the [[Tissue (biology)|tissue]] beneath the [[Cutis (anatomy)|cutis]] of the [[skin]], and ''[[emphysema]]'' refers to trapped air. Since the air generally comes from the [[chest cavity]], subcutaneous emphysema usually occurs on the chest, neck and face, where it is able to travel from the chest cavity along the [[fascia]].<ref name="pleural"> | |||
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cite book |editor=Bouros D |title=Pleural Disease (Lung Biology in Health and Disease) |publisher=Marcel Dekker |location=New York, N.Y |year=2004 |isbn=0-8247-4027-0 |oclc= |doi= |accessdate= 2008-05-16 |chapter=Pleural disease in the intensive care unit |author=Papiris SA, Roussos C |pages=771–777|url= http://books.google.com/books?id=PS8j3r31vWwC&pg=PA771&dq=subcutaneous+emphysema&lr=&client=firefox-a&sig=V8fQvguiH5tb-2xS6Sf8UnQGiGQ }} | |||
</ref> Subcutaneous emphysema has a characteristic crackling feel to the touch, a sensation that has been described as similar to touching Rice Krispies;<ref name="Lefor02"> | |||
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cite book |author=Lefor, Alan T. |title=Critical Care on Call |publisher=Lange Medical Books/McGraw-Hill, Medical Publishing Division |location=New York |year=2002 |pages= |isbn=0-07-137345-4 |oclc= |doi= |accessdate=2008-05-09| pages=238–240 | url= http://books.google.com/books?id=6pvRaVggws8C&pg=PA238&dq=subcutaneous+emphysema&sig=nvI2yrrJ2DklEEyepNTk7euYVq4 | |||
}} | |||
</ref> this sensation of air under the skin is known as ''subcutaneous crepitation''. | |||
Subcutaneous emphysema can result from puncture of parts of the [[respiratory system|respiratory]] or [[gastrointestinal system]]s. Particularly in the [[thorax|chest]] and neck, air may become trapped as a result of [[penetrating trauma]] (e.g., [[gunshot wound]]s or stab wounds) or [[blunt trauma]]. [[Infection]] (e.g., [[gas gangrene]]) can cause gas to be trapped in the subcutaneous tissues. Subcutaneous emphysema can be caused by medical procedures and medical conditions that cause the pressure in the [[alveoli]] of the lung to be higher than that in the tissues outside of them.<ref name="Maunder84"> | |||
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cite journal |author=Maunder RJ, Pierson DJ, Hudson LD |title=Subcutaneous and mediastinal emphysema. Pathophysiology, diagnosis, and management |journal=Arch. Intern. Med. |volume=144 |issue=7 |pages=1447–53 |year=1984 |month=July |pmid=6375617 |doi= |url= | |||
}} | |||
</ref> Its most common causes are [[pneumothorax]] and an improperly functioning [[chest tube]]. It can also occur spontaneously due to rupture of the alveoli, with dramatic signs.<ref name="Parker90"> | |||
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cite journal |author=Parker GS, Mosborg DA, Foley RW, Stiernberg CM |title=Spontaneous cervical and mediastinal emphysema |journal=Laryngoscope |volume=100 |issue=9 |pages=938–940 |year=1990 |month=September |pmid=2395401 |doi= |url= | |||
}} | |||
</ref> When the condition is caused by surgery it is called ''surgical emphysema''.<ref> | |||
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cite book |author=|title=Oxford Concise Medical Dictionary |publisher=Oxford University Press |location=Oxford, UK |edition=6th |year=2003 |isbn=0-19-860753-9 |oclc= |doi= |accessdate= | |||
}} | |||
</ref> The term ''spontaneous subcutaneous emphysema'' is used when the cause is not clear.<ref name="Parker90"/> | |||
Subcutaneous emphysema is not usually serious in and of itself, but the underlying causes, such as pneumothorax, can be.<ref name="Brooks98"> | |||
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cite book |author=Brooks DR |title=Current Review of Minimally Invasive Surgery |publisher=Current Medicine |location=Philadelphia |year=1998 |pages=36 |isbn=0-387-98338-4 |oclc= |doi= |accessdate= | |||
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</ref> Although the underlying conditions require treatment, subcutaneous emphysema usually does not; small amounts of air are reabsorbed by the body. However, subcutaneous emphysema can be uncomfortable and may interfere with breathing, and is often treated by removing air from the tissues, for example by using a chest tube. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Subcutaneous emphysema, sometimes abbreviated SCE or SE and also called tissue emphysema, occurs when gas or air is present in the subcutaneous layer of the skin. Subcutaneous refers to the tissue beneath the cutis of the skin, and emphysema refers to trapped air. Since the air generally comes from the chest cavity, subcutaneous emphysema usually occurs on the chest, neck and face, where it is able to travel from the chest cavity along the fascia.[1] Subcutaneous emphysema has a characteristic crackling feel to the touch, a sensation that has been described as similar to touching Rice Krispies;[2] this sensation of air under the skin is known as subcutaneous crepitation.
Subcutaneous emphysema can result from puncture of parts of the respiratory or gastrointestinal systems. Particularly in the chest and neck, air may become trapped as a result of penetrating trauma (e.g., gunshot wounds or stab wounds) or blunt trauma. Infection (e.g., gas gangrene) can cause gas to be trapped in the subcutaneous tissues. Subcutaneous emphysema can be caused by medical procedures and medical conditions that cause the pressure in the alveoli of the lung to be higher than that in the tissues outside of them.[3] Its most common causes are pneumothorax and an improperly functioning chest tube. It can also occur spontaneously due to rupture of the alveoli, with dramatic signs.[4] When the condition is caused by surgery it is called surgical emphysema.[5] The term spontaneous subcutaneous emphysema is used when the cause is not clear.[4] Subcutaneous emphysema is not usually serious in and of itself, but the underlying causes, such as pneumothorax, can be.[6] Although the underlying conditions require treatment, subcutaneous emphysema usually does not; small amounts of air are reabsorbed by the body. However, subcutaneous emphysema can be uncomfortable and may interfere with breathing, and is often treated by removing air from the tissues, for example by using a chest tube.
References
- ↑ Papiris SA, Roussos C (2004). "Pleural disease in the intensive care unit". In Bouros D. Pleural Disease (Lung Biology in Health and Disease). New York, N.Y: Marcel Dekker. pp. 771–777. ISBN 0-8247-4027-0. Retrieved 2008-05-16.
- ↑ Lefor, Alan T. (2002). Critical Care on Call. New York: Lange Medical Books/McGraw-Hill, Medical Publishing Division. pp. 238–240. ISBN 0-07-137345-4. Retrieved 2008-05-09.
- ↑
Maunder RJ, Pierson DJ, Hudson LD (1984). "Subcutaneous and mediastinal emphysema. Pathophysiology, diagnosis, and management". Arch. Intern. Med. 144 (7): 1447–53. PMID 6375617. Unknown parameter
|month=ignored (help) - ↑ 4.0 4.1
Parker GS, Mosborg DA, Foley RW, Stiernberg CM (1990). "Spontaneous cervical and mediastinal emphysema". Laryngoscope. 100 (9): 938–940. PMID 2395401. Unknown parameter
|month=ignored (help) - ↑ Oxford Concise Medical Dictionary (6th ed.). Oxford, UK: Oxford University Press. 2003. ISBN 0-19-860753-9.
- ↑ Brooks DR (1998). Current Review of Minimally Invasive Surgery. Philadelphia: Current Medicine. p. 36. ISBN 0-387-98338-4.