Subcutaneous Emphysema

Subcutaneous emphysema, also known as tissue emphysema, occurs when air seeps into the subcutaneous layer of the skin. The buildup of air or gases under the skin lends a bloated appearance to the affected parts of the body. Since the air that gets displaced and trapped in the subcutaneous layer often comes from the chest cavity, tissue emphysema generally affects the chest, neck or face. When the affected skin is touched, one can sense a strange crackling sensation due to the presence of trapped air within the subcutaneous layer of the skin. In medical terminology, this sensation arising due to presence of air under the skin is referred to as subcutaneous crepitation. Wondering what causes air to leak and get trapped under the skin? Scroll down to find out what causes tissue emphysema.

Subcutaneous Emphysema

Causes

Tissue emphysema could be caused due to a wide range of reasons. Air could seep through the lacerations on the skin that may have been caused due to injuries. Bullet wounds, surgical wounds or any type of blunt trauma to the skin can make one susceptible to this condition. Gas gangrene, a serious infection by pathogens on wounded skin that leads to tissue death may also cause tissue emphysema. Trauma to the trachea or bronchial tubes while placing a breathing tube or during a medical procedure called bronchoscopy could also give rise to displacement of air. At times, infections may also cause damage to the respiratory organs and affect their function.

Pneumothorax is one such condition that is viewed as the most common cause of tissue emphysema. To understand what causes pneumothorax, you must have some idea about the anatomy of the lungs. Well, lungs are paired organs that lie in the chest cavity. These are lined by pleura, which is a two-layered serous membrane. The inner serous membrane is attached to the lungs, while the outer membrane attaches to the chest wall. The pleural space, that is space between these two membranes is normally filled with a fluid. If the air-filled sacs present in the lungs rupture, then air starts leaking from the sacs into the pleural space. This causes pressure to build up and causes the lungs to collapse partially or completely. This condition is medically referred to as pneumothorax. It can cause displacement of air to the subcutaneous layer of the skin. It has been seen that pneumothorax that occurs with rib fracture increases the risk of tissue emphysema to a great extent.

Treatment

Tissue emphysema must not be confused with the progressive lung disease called pulmonary emphysema. While the life expectancy and prognosis are quite poor for pulmonary emphysema, tissue emphysema is usually not a cause of serious concern. Tissue emphysema doesn't always cause pain or other distressing symptoms. However, the conditions that give rise to this form of emphysema are often quite serious. The symptoms vary depending on the underlying cause. For instance, collapsed lungs is a very serious condition that causes serious symptoms such as chest pain, low blood pressure and shortness of breath. If a lot of air gets accumulated in the pleural space, it may even lead to cardiovascular dysfunction. Swelling of the neck or face, and crackling sensation on touching the affected skin are the most common symptoms. In severe cases, one may experience chest pain, neck pain, wheezing, difficulty in swallowing or breathing problems.

If the sufferer is having trouble breathing, then small incisions might be made to release the trapped air. If air is trapped in the chest region, then catheters or chest tubes might be placed for removing the air. Treating the underlying disease can help in alleviating the symptoms to a great extent. Doctors often follow a symptomatic approach for the treatment of this condition. For instance, shortness of breath can be treated by providing supplemental oxygen. Painkillers or anti-inflammatory drugs are prescribed for pain relief. In case of traumatic injuries to the trachea, esophagus or bronchial tubes, the recovery would depend on the extent of damage. Generally corrective surgery and drug therapy would be required for treating such injuries. It's therefore essential that a thorough medical checkup be performed if one suffers from such traumatic injuries.

Though subcutaneous emphysema is not a life-threatening disease in itself, the underlying conditions that may give rise to it are usually grave in nature. If left unresolved, such conditions may have serious repercussions on one's health. It is therefore important that one consults a doctor on experiencing these aforementioned symptoms. While you are recovering from conditions that cause tissue emphysema, make sure that you refrain from any activity that can cause stress on the respiratory organs.