Subcutaneous emphysema, which is an accumulation of gas bubbles in the subcutaneous tissue and other tissues, is often a serious symptom that indicates the progression of gas phlegmon or gangrene. It occurs for several reasons. So it can arise due to the penetration of atmospheric gases into the tissue, as well as due to the accumulation of gases formed directly in the tissues.
Penetration into the internal tissues of gases most often occurs from the airways (if damaged) and the respiratory system. In rare cases, the source of emphysema is the digestive tract (with mechanical damage). It is also possible the occurrence of emphysema with a rupture of the stomach due to pyloric stenosis. Air entering through an open wound of the skin is possible when it has a suction effect (most often with external pneumothorax) or with a penetrating wound of large joints (most often of the knee). Atmospheric air entering through the wound by inhalation (into the pleural cavity), during flexion (in the joint cavity of the knee) during expiration is displaced back, and during extension, the air is partially released through the wound to the outside, although it partially penetrates into the surrounding tissues (most often - in fiber).
Subcutaneous emphysema can reach impressive sizes with valve external pneumothorax, in which the air displaced from the pleural cavity penetrates the tissues. Small emphysema sometimes occurs in the area of the puncture opening and gunshot wounds inflicted by point-blank shots.
Subcutaneous emphysema has the following symptoms: diffuse swelling, not accompanying inflammatory changes in the skin, resembling edema; gas crepitus, detected by palpation, resembling a crunch of snow; tympanitis. To determine the early degree of emphysema caused by gas formation in the internal tissues, provoked by anaerobic infection, there are several special techniques. The most convincing results are obtained during the X-ray examination.
Subcutaneous formations, even of significant size, often do not pose a serious danger, since they have diagnostic value, which indicates damage to a particular cavity or organ. They disappear spontaneously after gas is absorbed in the fiber. Subcutaneous emphysema disappears mainly in a few days, so it does not require therapeutic measures, although you need to be completely sure that emphysema that occurs with an open wound is not associated with anaerobic infection, with interstitial gas formation.
A serious danger arises when the emphysema of the chest wall quickly increases, passing to the neck, since it can contribute to the development of mediastinal syndrome. In this case, urgent surgery is needed to stop the injection of air into the internal tissues.
There are several varieties of subcutaneous enphysema:
- septic - occurs as a result of the development of putrefactive or anaerobic infection;
- traumatic - occurs as a result of damage to the walls of the respiratory system;
- universal - occurs as a result of penetration into the tissue of atmospheric air from damaged lungs and spreads to the entire surface of the body.
Subcutaneous emphysema, the treatment of which is carried out only in especially severe cases, practically does not pose a health hazard to the patient, but nevertheless, with an increase in the size of this subcutaneous formation, you should immediately consult your doctor.