Gravis subcutaneous emphysema of the upper limb

A case report

Abstract

The authors present the case of a 25-year-old female patient with post-traumatic severe subcutaneous emphysema of the upper limb and neck region with a tendency to relapse. On the day of his admission, following a banal trauma, subcutaneous emphysema appeared on the left upper limb without other systemic abnormalities. Surgery became necessary due to the patient's rapidly deteriorating general condition. The extent of the emphysema gradually increased before stagnating and finally regressing. He was discharged cured, no recurrence or complaints were mentioned during the one-week control examination. The patient presented again one month after the emission, where compared to the previous occasion, subcutaneous emphysema located proximally, covering the entire left upper limb and the neck region was confirmed. Despite the exploration and necrectomy, the patient's general condition began to deteriorate. Laboratory values did not show any significant differences, gas-forming pathogens could not be detected. Wound revisions were performed every two days, and operative and intravenous antibiotic therapy was supplemented with high-flow mask oxygen therapy. The patient's general condition finally began to improve, his wounds healed without reaction, the subcutaneous emphysema was absorbed and did not recur. He was discharged cured, appeared in control examinations, and has had no complaints since then.