Management of Bilateral Extensive Subcutaneous Emphysema

Subcutaneous emphysema (SE) occurs when there is a trapping of air under the skin due to leakage either from the gastrointestinal or respiratory tract. SE is commonly associated with procedural complications such as chest tube insertion, cardiothoracic surgery; as well as barotrauma, infection and malignancy. The majority of SE resolve spontaneously without any active intervention. However, it is a medical emergency as SE may spread and compromise the airway. Various interventions had been described in other literature. We would like to illustrate a case of extensive SE one day after chest tube insertion for secondary spontaneous pneumothorax, successfully relieved by usage of cannulas and low-grade pressure suction.