Surgical Emphysema

Surgical Emphysema or Subcutaneous Emphysema-

 means presence of air in the subcutaneous plane.

Right Sided Multiple Rib Fractures with Subcutaneous Emphysema

Characteristic clinical finding is crackling feel or creps.

 

The blown out appearance is sometimes described as 

Michelin Man (Tyre Man) appearance.

Causes

1. Multiple Rib Fractures- Pleural Tear

2. Penetrating Chest Injury  (Stab /Gunshot)

3. Rupture of  Emphysamatic Bullae on to the mediastinum.

4. Rupture Esophagus

5. Tracheal Injury

6. Facial Bone Fractures ( as sinuses contain air )

7. Infection with Gas forming organisms

Other Conditions producing Creps on palpation

1. Face, Neck, Chest - Surgical Emphysema

2. Bone – Definitive Sign of  fracture

3. Joint- Osteo Arthritis

4. Tendon – Teno Synovitis,inflammation of tendon sheath.