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[Massive subcutaneous emphysema--management using subcutaneous drains].

Maria Sucena¹, Fernando Coelho, Teresa Almeida

¹Assistente Hospitalar de Pneumologia. maria.sucena@hotmail.com

Revista Portuguesa De Pneumologia

|May 4, 2010

Summary

Massive subcutaneous emphysema, a complication of chest procedures, can cause significant discomfort. This case demonstrates that subcutaneous drains provide safe, effective, and rapid symptom relief for severe cases.

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Area of Science:

Thoracic Surgery
Pulmonology
Medical Complications

Background:

Massive subcutaneous emphysema is a known complication of invasive procedures and medical conditions.
While often asymptomatic, severe subcutaneous emphysema causes significant patient discomfort.
Conservative management is typical, but may not address severe cases effectively.

Observation:

A patient with spontaneous secondary pneumothorax and large air leak developed massive, rapidly progressing subcutaneous emphysema after chest tube displacement.
The patient experienced extreme discomfort due to the severe subcutaneous emphysema.
Conservative treatment was not detailed, but the severity prompted an alternative approach.

Findings:

Two subcutaneous drains were inserted under local anesthesia into the anterosuperior thoracic wall on both sides.
The drains were connected to drainage bags for effective decompression.
This intervention led to dramatic clinical improvement and immediate symptom relief.

Implications:

Subcutaneous drainage is a safe, easy, and effective technique for managing severe subcutaneous emphysema.
This method offers immediate symptom relief for patients suffering from this uncomfortable condition.
The findings support considering subcutaneous drainage as a primary intervention for severe subcutaneous emphysema, especially when conservative measures fail or are insufficient.