FAQ - Subcutaneous Emphysema
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Subcutaneous Emphysema?


I recently noticed a "darkened" patch on my back, about the size of a quarter-when I push on it it crackled-A LOT-just like SQ Emphysema. I realize now that THIS was in fact SQE, but why the hell would I have that if I hadn't had an pneumo or trauma or even surgery or ANYTHING??? I am, however a smoker. My son recently died and I have been smoking like a chimney, too.
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SubQ Emphysema is directly related to a pneumo and they can actually occur spontaneously in some people. The smoking probally isn't going to help much either. Are you better now?   (+ info)

Where can I get a Xray image of subcutaneous emphysema?


I have to describe the plain xray appearance of subcutaneous emphysema for a university presentation.

Does anyone know of any good websites that contain xrays of this pathology?

There are a handful of Xrays which came up on google images but any further leads would be appreciated.
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I looked for some images of some sub-Q for ya, but couldn't find a whole lot either. I did find this site which had an xray pic.

http://content.nejm.org/cgi/content/short/342/18/1333?query=prevarrow

Sorry-I have some textbooks with some pics, but that doesn't help you any! :)

Hope this helps some!  (+ info)

how long does it take for subcutaneous emphysema to be absorbed?


Sometimes it may take days for subcutaneous emphysema to be absorbed. In the ICU, most of my patients would have a chest tube connected to suction to resolve it. What is the clinical scenario in your case?  (+ info)

Could the CPAP device be a cause of Subcutaneous emphysema?


  (+ info)

what are the causes, pathophisiology & management of subcutaneous emphysema?


subcutaneous emphysema is when air is trapped underneath the skin.
example, with a chest wound -- the air goes in underneath the skin because of the opening.
other causes include stabbing, gun shot wounds, other penetrations, or blunt trauma.

another common cause is too much pressure when using the mechanical ventilator.  (+ info)

what is the treatment for subcutaneous emphysema?


Subcutaneous emphysema isn't a problem by itself. This is just gas bubbles under the skin that can be felt with the fingers. However, it may be a sign that something is happening which could require treatment, and should be figured out.

There are three ways in which gas gets under the skin. First, in some cases rips in the tissue of the lung leak air, but the air doesn't stay in the chest. In these situations, it tracks along under the surface of the lung and then into the soft tissue around the heart. From there, it tracks out through the muscles of the neck till it reaches the skin. It's typically first detectable around the collar bones, but it can spread to the face, arms and torso very quickly. I've seen people blow up like the "Michelin man" from this. As long as lung function isn't compromised, this isn't an emergency. If lung function is compromised by air also leaking into the chest cavity, then the air needs to be drained with a "chest tube". Some people who have problems like this eventually benefit by having the leaky portion of the lung removed surgically.

On rare occassions, the source of air leak isn't the lung, but is instead the digestive tract. Tears in the lining of the esophagus can lead to subcutaneous emphysema and if so, this is highly likley to require surgery in order to keep infection out of the chest. I have also seen gas escape from the rectum into the wall of the intestine and eventually become detectable under the skin. This did not make the patient sick, but after a month of recovery, the patient underwent elective surgery to remove the offending segment of colon so that it wouldn't happen again.

All of the situations so far mentioned regard gasses leaking from some gas filled organ - either the pulmonary system or the digestive system. I'm lumping this all together as "the first way" of the 3 that I'm listing. These are all leaks from hollow spaces.

The second major way for gas to get under the skin is from gas-forming infection. This is scary. It really happens. In some cases of skin infection, the right mix of bacteria get involved and they begin to cooperate. The infection spreads rapidly and all of the tissue involved, dies. Once dead, the tissue no longer has blood flow, and the oxygen is quickly depleted. Anerobic bacteria (ones that thrive in environments with little or no oxygen) thrive. Anerobes are often gas-forming organisms. In this case, the presence of gas in the soft tissues under the skin, along with signs of infection such as redness, blistering and generalized illness signs such as fever, elevated white blood cell count and high heart rate, all come together to point at an emergency diagnosis: "necrotizing infection". Necrotizing soft tissue infections are surgical emergencies. If patients don't have the dead material surgically excised within a few hours, they can quickly become un-recoverable and will die from the complications of the infection.

The third, and most common reason for subcutaneous emphysema is "iatrogenic" which means that it results from something done by the doctor. In my case, the most common reason is the use of laparoscopic surgical technique. In laparoscopic surgery, instruments are inserted through the abdominal wall into the abdominal cavity, along with a a long thin video camera lens. The surgery is performed inside a "closed" abdomen under video imaging. The abdomen is actually inflated with carbon dioxide to maintain the working space. In most cases, the carbon dioxide stays in the abdominal cavity till the end of the operation and then is released. In some cases, however, the gas slowly trickles into the tissues of the abdominal wall and becomes detectable under the skin. By the end of some long operations, there is a really REALLY annoying amount of gas under the skin. However, it's sterile, it's harmless, and it's gone in a day or two.

Sometimes patients have chronic need for mechanical ventilation due to critical illness. In some cases, the pressurized gas used in the ventilation circuit can escape through injuries in the wall of the airway. This can lead to subcutaneous emphasema too. Again, like the other situations, this isn't a problem by itself but it leads to an investigation about where the air is coming from in order to see if there is a problem that needs treatment.

In short, three ways that gas can get under the skin include:

1) Spontaneous escape from an air containing organ such as the lung or the intestine.

2) Formation of gas in the subcutaneous space due to infection.

3) Inadvertant entry of pressurized gas due to medical equipment.

As a footnote, I have heard of (but never seen) cases where industrial injuries occuring with the use of pressurized air systems can lead to subcutaneous gas just by injection from the air source. I'm not sure how to file that one!!

I hope that helps.

Feel free to contact me if you have additional questions on this topic.  (+ info)

how many people acquire subcutaneous emphysema? ?


http://en.wikipedia.org/wiki/Subcutaneous_emphysema  (+ info)

What is the chance of getting emphysema if you have not smoked in 30 years?


My grandmother has not smoked in 30 years and was in good health and then all of a sudden she has emphysema! She was also diagnosed with pnemonia as well. Thats how they found the emphysema.
They said it was from smoking but i have been doing research and i want to ask them if she has an alpha-1 antitrypsin deficiency. Why have they not diagnosed her sooner if its so severe?
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When Dr's are clueless, smoking becomes the number 1 cause of everything. I'm sorry about your grandmother, but I'd get another opinion.  (+ info)

Why are the buttocks a good place to administrate subcutaneous insulin?


I've read administering subcutaneous insulin must be done in places known for their adipose tissue, such as: forearms, lower back toward the sides, internal and external part of the thighs, abdomen, and the buttocks, which I'm told to be the best way to inject insulin. What metabolic advantage do buttocks have in comparison with other adipose areas?
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Adipose tissue is just a fancy way of saying fat that lies underneath the skin. The buttocks actually are the site of last choice for injection, as they are the area of slowest absorption. First choice is the abdomen, about 2 inches from the belly button. Next choice is the thigh, the outer portion at least 4 inches from the knee and 4 inches down from the crease where leg meets body. The third spot of choice is the arm, the region between the shoulder and elbow, on the outside. This is a bit tough to do one handed, and you have to be careful you are indeed doing a subcutaneous delivery. Final spot is the buttocks, the upper outer portion. The thing is you want fatty tissue, but you want to consider what sort of physical activity that part is going to get shortly after the injection as well. Muscle use will increase the absorption rate in most cases- although having a lot of adipose tissue, like in the buttocks, can also slow it down some. So if your sugar is high, you would likely want to do an abdominal injection rather than a buttocks one. But if you planned to go play tennis, you would not want to inject your racket arm. You also would want to avoid the legs if you planned to go for a jog or long walk. Also, if you needed to take your insulin but wanted a slower aborption rate, the buttocks would be your choice spot- providing your glucose level didn't need to come down and you weren't planning to eat very soon. You pretty much learn your own rates of absorption over time, and can choose your site better according to need and site rotation requirements.   (+ info)

What are some of the common remedies for lung emphysema at old age?


lung emphysema remedies.
medecines and such.
just a list of drugs and such will be ok.
thank you.
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There aren't any cures.

Bronchodilator inhalers such as albuterol can help increase your airflow. Antibiotics if there is any infection, and oxygen if your blood oxygen is too low.  (+ info)

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