Surgical Emphysema
Definition
- Surgical emphysema is the entry of air into the tissues or spaces of the body.
Causes
- Trauma to the chest or abdomen
- Surgical procedures, especially those involving the abdomen or chest
- Pneumothorax or pneumoperitoneum
- Spontaneous rupture of the lung or intestine
Pathology
- Air enters the soft tissues through a defect in the lung or intestine
- Air accumulates in the soft tissues, leading to swelling and crepitus
- Crepitus is the characteristic crunching or crackling sound heard when the affected area is palpated
Types
- Primary: caused by trauma or surgery
- Secondary: caused by underlying conditions, such as chronic obstructive pulmonary disease (COPD) or a lung abscess
Clinical Features
- Crepitus or a crunching sound over the affected area
- Swelling or soft tissue mass
- Shortness of breath or respiratory distress
- Chest pain or discomfort
- Systemic signs of shock or sepsis
Investigations
- Chest X-ray or CT scan to confirm the presence of air in the soft tissues
- Arterial blood gas to assess respiratory function
- Complete blood count and blood culture to rule out infection
Complications
- Respiratory failure
- Sepsis or septic shock
- Airway compromise
- Cardiac arrest
Management
- Emergency surgical intervention to repair any underlying defect or injury
- Antibiotics to treat or prevent infection
- Oxygen therapy to support respiratory function
- Pain management to control discomfort
- Close monitoring for signs of respiratory or cardiac compromise
Treatment
- Surgery to repair any underlying defect or injury
- Drainage of air from the soft tissues to reduce swelling
- Antibiotics to treat or prevent infection
- Oxygen therapy to support respiratory function
- Close monitoring for signs of respiratory or cardiac compromise
Homoeopathic Medicines
- Arnica montana: for trauma and soft tissue injury
- Belladonna: for fever and infection
- Hypericum: for nerve damage and numbness
- Rhus toxicodendron: for inflammation and pain
- Silica: for swelling and soft tissue injury