Management of Extensive Subcutaneous Emphysema with Vacuum Drainage, without Closed Thoracostomy

Management of extensive subcutaneous emphysema with a subcutaneous drain

We present a case of a gentleman in his 70s with extensive subcutaneous emphysema. Usually self-limiting, subcutaneous emphysema around the thoracic inlet can rarely lead to airway and cardiovascular compromise by compression of structures in the neck. This patient presented with a large pneumothorax on a background of chronic obstructive pulmonary disease (COPD). This was initially treated wit...

Using a closed drainage system without vacuum.

Management of extensive subcutaneous emphysema and pneumomediastinum by micro-drainage: time for a re-think?

Extensive subcutaneous emphysema (ESE) is not only disfiguring, uncomfortable and alarming for the patient, but can rarely be associated with airway compromise, respiratory failure and death. Traditionally considered a cosmetic nuisance, few reports on interventions to relieve ESE exist. Most interventions are too invasive and have not been widely used. Fenestrated catheters have been reported ...

Spontaneous pneumomediastinum originating from extensive subcutaneous emphysema.

A 76-year-old man with chronic obstructive pulmonary disease presented with new swelling in the neck and face. Physical examination was notable for massive subcutaneous emphysema as the cause of the swelling, which extended from the patient’s trunk and neck onto his face (Picture A). A CT scan showed extensive subcutaneous emphysema throughout the neck and thorax as well as a pneumomediastinum ...

Extensive subcutaneous emphysema resembling necrotizing fasciitis.

Necrotizing fasciitis is an aggressive, invasive soft tissue infection. Because it can rapidly progress to patient instability, prompt diagnosis followed by urgent debridement is critical to decreasing mortality. Despite the importance of early diagnosis, necrotizing fasciitis remains a clinical diagnosis, with little evidence in the literature regarding the effectiveness of diagnostic tools or...