Subcutaneous emphysema occurs when air gets into tissues under the skin. This usually occurs in the skin covering the chest wall or neck, but can also occur in other parts of the body.

Crepitus; Subcutaneous air; Tissue emphysema

Subcutaneous emphysema can often be seen as a smooth bulging of the skin. When a health care provider feels (palpates) the skin, it produces an unusual crackling sensation as the gas is pushed through the tissue.

This is a rare condition. When it does occur, possible causes include:

• Collapsed lung (pneumothorax), often occurring with a rib fracture
• Facial bone fracture
• Ruptured bronchial tube
• Ruptured esophagus

This condition can happen due to:

• Blunt trauma
• Forceful vomiting" (Boerhaave's syndrome)
• Gun shot wounds
• Stabbing
• Rarely after medical procedures such as endoscopy, a central venous line, intubation, and bronchoscopy

Air can also be found in between skin layers on the arms and legs or torso during certain infections, including gas gangrene.

Images

Skin layers

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Subcutaneous emphysema Treatment

Review Date: 11/17/2010
Reviewed By: Eric Perez, MD, Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)