A 75-year-old Australian man was left with a disfigured face after undergoing surgery to remove part of his right lung. During the postoperative period, the patient developed a rare condition called subcutaneous emphysema, which left his face swollen to the point of preventing him from opening his eyes.
Subcutaneous emphysema is a kind of air pocket that forms under the skin. In the case of the elderly, it continued to grow and extended from the pelvis to the face. The condition also affected the neck and chest. Doctors used a chest tube to remove the air pockets and he made a full recovery.
In an article published yesterday (1) in the New England Journal of Medicine, an Australian research team highlighted the rare case, although it did not explain how long the man had suffered from COPD (Chronic Obstructive Pulmonary Disease).
Doctors performed lung volume reduction surgery on the right upper lobe of the organ. The procedure is common for people who suffer from COPD and whose condition has deteriorated to the point where part of the lung needs to be removed.
This surgery is often recommended to help alleviate the breathing problems that the chronic lung condition often causes. Due to complications from the surgery, however, the man suffered a pulmonary effusion and, soon after, a subcutaneous emphysema.
Tube to remove air pockets
To reverse the condition, doctors used a chest tube – placed between the lining of his skin and muscle – just below his ribs. Two hours after the start of treatment, the swelling had already significantly decreased. Within five days, the condition had completely disappeared.
A week after the tube was removed, the elderly man was discharged from the hospital, where he left in good condition.
Rare, subcutaneous emphysema occurs in less than 0.43% of people worldwide, according to a report from the University of California, Los Angeles, published earlier this year.
More than seven out of ten cases occur in men. In many cases, the condition is not clinically detectable, as subcutaneous emphysema does not always form a visible bulge.