Tuberc Respir Dis.  2006 Aug;61(2):178-183.

The Treatment of Massive Spontaneous Subcutaneous Emphysema by Multiple Intravenous Catheter and Continuous Suction Drainage

• Kim SY
• Uom KS
• Lee YS
• Huh KR
• Kwon CW
• Jang SH
• Kim DG
• Jung KS

Abstract

A-61-year-old COPD patient was hospitalized due to dyspnea and was diagnosed with acute exacerbation of COPD. During the hospital stay, the patient's dyspnea was aggravated by massive spontaneous subcutaneous emphysema. Multiple 16 gauge intravenous catheters were inserted at the midclavicular line for drainage. Although subcutaneous catheter drainage was carried out, respiratory failure developed with an increased in massive subcutaneous emphysema. Continuous suction drainage with wall suction was applied resulting in the rapid resolution of the subcutaneous emphysema. We report a case of the that effective management of massive subcutaneous emphysema using multiple 16 gauge intravenous catheters with continuous suction.

Keyword

Massive spontaneous subcutaneous emphysema; Catheter drainage; Continuous suction

MeSH Terms

Catheters*
Drainage
Dyspnea
Humans
Length of Stay
Pulmonary Disease, Chronic Obstructive
Respiratory Insufficiency
Subcutaneous Emphysema*
Suction*

Figure

• 

  Figure 1 Chest X-ray shows massive subcutaneous emphysema(A). After continuous suction drainage with multiple intravenous catheters insertion, subcutaneous emphysema resolved(B).

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  Figure 2 High Resolution Computed Tomography of chest shows upper thorax(A) and lower thorax(B) of patient. High resolution computed tomography shows massive subcutaneous emphysema from cervical to chest wall, bilateral pneumothorax, pnemomediastinum, diffuse bilateral emphysema and bullaes and inactive pulmonary tuberculosis and pleural thickening in LUL and superior segment of LLL.

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  Figure 3 Gross appearance(A) and schematic diagram(B) of multiple intravenous catheters and continuous suction drainage by wall suction.

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