Subcutaneous emphysema on Chest XRay



Etiologies:   Pneumothorax (spontaneous or traumatic), trauma (tracheobronchial injury, barotrauma), esophageal perforation/rupture, iotrogenic (from positive pressure ventilation, VATS, bronchoscopy), cocaine inhalation 



Management:  assume underlying pneumothorax even if not obvious on x-ray, control pain, if possible avoid positive pressure ventilation (PPV), may require thoracostomy tube (especially if patient needs PPV) consultation with cardiothoracic surgery and interventional pulmonology with esophageal or tracheobronchial injury, may require bronchoscopy for further evaluation



Often resolves spontaneously over 2 weeks



#Subcutaneous #emphysema #ChestXRay #CXR #Clinical #Radiology