May signal a serious underlying pathology
- By: Nicholas F Brown, Li-An Wong-Taylor, Michael Beckles
Subcutaneous (or surgical) emphysema is the presence of gas in the subcutaneous soft tissues, which may be detected clinically by swelling of the affected area and crepitus on palpation. Subcutaneous emphysema usually affects the neck or thorax, but it may also be found in the supraclavicular regions, abdominal wall, perineal region, or upper or lower limbs.1
It is not an uncommon presentation, and most medical students will encounter it, although the incidence remains undefined. The causes of subcutaneous emphysema are numerous and diverse, so determining a cause can be challenging. It is normally a benign and self limiting condition, but it can occasionally be associated with life threatening pathologies that must not be missed.
Subcutaneous gas may arise from a local source, or gas may travel along fascial planes from a distant source. Distant pathologies may lead to subcutaneous emphysema of the neck because of the anatomy of the