Air leaks into the skin, causing a condition called subcutaneous emphysema, when air becomes trapped under the skin.
What is Subcutaneous Emphysema?
Subcutaneous emphysema occurs when air enters the tissues beneath the skin's surface. This trapped air can cause swelling and a crackling sensation when the affected area is touched, due to the air bubbles moving under the skin. It most commonly affects the chest and neck area but can occur in other parts of the body.
Common Causes of Air Leaking Into Skin:
While subcutaneous emphysema may sound alarming, it is often related to an underlying issue that needs to be addressed. Common causes include:
- Trauma: Blunt or penetrating injuries to the chest or neck can introduce air into the subcutaneous tissues.
- Lung Conditions: Ruptured air sacs in the lungs (e.g., pneumothorax, pneumomediastinum) can allow air to escape into the surrounding tissues.
- Surgical Procedures: Certain surgeries, particularly those involving the chest, neck, or abdomen, can inadvertently introduce air into the subcutaneous space.
- Infections: Gas-producing bacterial infections can cause air to accumulate under the skin.
- Ruptured Esophagus: A tear in the esophagus, often due to vomiting or injury, can allow air from the digestive tract to leak into the surrounding tissues.
- Mechanical Ventilation: Positive pressure ventilation can sometimes cause air to leak from the lungs.
- Explosions or Barotrauma: Sudden pressure changes can cause air to be forced into the subcutaneous tissues.
Symptoms of Subcutaneous Emphysema:
The primary symptom is a crackling sensation (crepitus) upon touching the skin, often accompanied by swelling. Other symptoms may include:
- Pain or discomfort in the affected area
- Tenderness
- Swelling
- Changes in voice (if the neck is affected)
- Difficulty breathing (if severe)
Diagnosis and Treatment:
A physical examination can often diagnose subcutaneous emphysema. Imaging tests, such as X-rays or CT scans, are typically performed to identify the underlying cause. Treatment focuses on addressing the underlying condition. In many cases, subcutaneous emphysema resolves on its own as the air is reabsorbed by the body. However, in severe cases, treatment may include:
- Oxygen therapy
- Needle aspiration or chest tube insertion to remove trapped air
- Antibiotics for infections
- Surgery to repair damaged tissues.
