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BMJ Case Reports Mar 2014
Topics: Barotrauma; Bone Marrow Transplantation; High-Frequency Ventilation; Humans; Male; Middle Aged; Multiple Myeloma; Radiography; Respiratory Distress Syndrome; Subcutaneous Emphysema; Ventilator-Induced Lung Injury
PubMed: 24642172
DOI: 10.1136/bcr-2013-201127 -
JSLS : Journal of the Society of... 2014Subcutaneous emphysema and gas extravasation outside of the peritoneal cavity during laparoscopy has consequences. Knowledge of the circumstances that increase the... (Review)
Review
BACKGROUND
Subcutaneous emphysema and gas extravasation outside of the peritoneal cavity during laparoscopy has consequences. Knowledge of the circumstances that increase the potential for subcutaneous emphysema is necessary for safe laparoscopy.
METHODS
A literature review and a PubMed search are the basis for this review.
CONCLUSIONS
The known risk factors leading to subcutaneous emphysema during laparoscopy are multiple attempts at abdominal entry, improper cannula placement, loose fitting cannula/skin and fascial entry points, use of >5 cannulas, use of cannulas as fulcrums, torque of the laparoscope, increased intra-abdominal pressure, procedures lasting >3.5 hours, and attention to details. New additional risk factors acting as direct factors leading to subcutaneous emphysema risk and occurrence are total gas volume, gas flow rate, valveless trocar systems, and robotic fulcrum forces. Recognizing this spectrum of factors that leads to subcutaneous emphysema will yield greater patient safety during laparoscopic procedures.
Topics: Humans; Laparoscopy; Pneumoperitoneum, Artificial; Risk Factors; Subcutaneous Emphysema
PubMed: 24680136
DOI: 10.4293/108680813X13693422520882 -
Ear, Nose, & Throat Journal Mar 2021
Topics: Adenoidectomy; Child, Preschool; Face; Female; Humans; Medical Illustration; Postoperative Complications; Sleep Apnea, Obstructive; Subcutaneous Emphysema; Tonsillectomy
PubMed: 31547712
DOI: 10.1177/0145561319872723 -
Acta Medica (Hradec Kralove) 202074 year-old-man, former smoker, with chronic obstructive pulmonary disease GOLD grade 4, group D, with emphysema component, treated in a pulmonary rehabilitation...
74 year-old-man, former smoker, with chronic obstructive pulmonary disease GOLD grade 4, group D, with emphysema component, treated in a pulmonary rehabilitation program, on oxygen therapy and nocturnal bi-level positive airway pressure (BiPAP) ventilation. During the night he had a traumatic rib fracture (5-11th right ribs) but still he used BiPAP ventilation during the sleep. In the morning after he presented with a diffuse and massive emphysema in the face, thorax and abdominal regions. On physical examination, the patient presented with massive swelling and crepitus on palpation. A chest computed tomography (CT) scan confirmed a diffuse subcutaneous emphysema and revealed a mediastinal emphysema and bilateral small pneumothorax. A fast resolution of the emphysema was of paramount importance as the patient was severely agitated due to his inability to open both eyes, and the need to reintroduce BiPAP ventilation as soon as possible. It was placed a fenestrated subcutaneous catheter on left hemithorax and a subcutaneous ostomy on right hemithorax for comparative purpose. It was also performed a confluent centripetal massage towards drainage orifices, with immediate and substantial improvement of emphysema, especially in left hemithorax, and progressive ocular opening. Further emphysema absorption occurred during hospitalization.
Topics: Aged; Continuous Positive Airway Pressure; Humans; Male; Mediastinal Emphysema; Oxygen Inhalation Therapy; Pulmonary Disease, Chronic Obstructive; Rib Fractures; Subcutaneous Emphysema; Tomography, X-Ray Computed
PubMed: 33355081
DOI: 10.14712/18059694.2020.63 -
The New England Journal of Medicine Apr 2019
Topics: Adolescent; Asthma; Humans; Lung; Male; Mediastinal Emphysema; Radiography, Thoracic; Subcutaneous Emphysema
PubMed: 30970192
DOI: 10.1056/NEJMicm1811009 -
Revista Da Associacao Medica Brasileira... Feb 2018Subcutaneous emphysema (SE) is a clinical condition that occurs when air gets into soft tissues under the skin. This can occur in any part of the body depending on the... (Review)
Review
INTRODUCTION
Subcutaneous emphysema (SE) is a clinical condition that occurs when air gets into soft tissues under the skin. This can occur in any part of the body depending on the type of pathology. The most common site is under the skin that covers the chest wall or neck. It is characterized by painless swelling of tissues. The classic clinical sign is a crackling sensation upon touch, resembling that of touching a sponge beneath your fingers.
OBJECTIVE
To describe a new way to diagnose subcutaneous emphysema.
METHOD
Our finding was a matter of serendipity while inspecting a patient with subcutaneous emphysema using a stethoscope. Instead only hearing the patient's chest, the stethoscope was gently pressed against the skin with SE and so we were able to detect a different sound.
RESULTS
This new way to diagnose subcutaneous emphysema consists in pressing the diaphragm part of stethoscope against the patient's skin where SE is supposed to be. Thus, we are able to hear a sound of small bubbles bursting. Crackle noise has an acoustic emission energy that varies between 750-1,200 Hz, considered high frequency.
CONCLUSION
Although currently the use of imaging methods is widespread worldwide, we would like to strengthen the value of clinical examination. Auscultation is an essential diagnostic method that has become underestimated with the advances of healthcare and medicine as a whole. We therefore propose a different approach to diagnose SE.
Topics: Auscultation; Diagnosis, Differential; Humans; Noise; Subcutaneous Emphysema
PubMed: 29641666
DOI: 10.1590/1806-9282.64.02.159 -
Medicina Clinica Apr 2022
Topics: COVID-19; Humans; Mediastinal Emphysema; Subcutaneous Emphysema
PubMed: 35115171
DOI: 10.1016/j.medcli.2021.11.006 -
Pulmonology 2020
Topics: Barotrauma; Cannula; Diving; Humans; Incidence; Male; Mediastinal Emphysema; Mediastinum; Oxygen Inhalation Therapy; Pressure; Radiography, Thoracic; Subcutaneous Emphysema; Treatment Outcome; Young Adult
PubMed: 31735688
DOI: 10.1016/j.pulmoe.2019.09.010 -
Anesthesia Progress 1985This case describes the development of subcutaneous emphysema following restorative dentistry performed under general anesthesia. Initial treatment consisted of...
This case describes the development of subcutaneous emphysema following restorative dentistry performed under general anesthesia. Initial treatment consisted of intravenous epinephrine and dexamethasone due to difficulty in breathing and laryngeal stridor. Dexamethasone and other adjunctive drugs were administered over the 4 days following surgery while the symptoms subsided. The author emphasizes the importance of early recognition and prompt management in managing this unusual complication.
Topics: Adult; Dental Restoration, Permanent; Emphysema; Face; Female; Gingivectomy; Humans; Neck; Subcutaneous Emphysema
PubMed: 3865564
DOI: No ID Found -
Jornal Brasileiro de Pneumologia :... 2018
Topics: Adult; Cough; Humans; Male; Mediastinal Emphysema; Neck; Subcutaneous Emphysema; Syndrome
PubMed: 30517342
DOI: 10.1590/S1806-37562018000000180