Cargando…

Traumatic subcutaneous emphysema of the hand/forearm: A case report

Subcutaneous emphysema is commonly associated with infection caused by gas-producing organisms. In this case report, we describe a rare instance of traumatic subcutaneous emphysema of the hand and forearm caused by a puncture injury to the first web space of the hand. Our objective is to increase aw...

Descripción completa

Detalles Bibliográficos
Autores principales: Saela, Stephen, Decilveo, Alexander, Isaac, Roman, Patel, Deepak V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9751530/
https://www.ncbi.nlm.nih.gov/pubmed/35450804
http://dx.doi.org/10.1016/j.cjtee.2022.04.001
_version_ 1784850493278781440
author Saela, Stephen
Decilveo, Alexander
Isaac, Roman
Patel, Deepak V.
author_facet Saela, Stephen
Decilveo, Alexander
Isaac, Roman
Patel, Deepak V.
author_sort Saela, Stephen
collection PubMed
description Subcutaneous emphysema is commonly associated with infection caused by gas-producing organisms. In this case report, we describe a rare instance of traumatic subcutaneous emphysema of the hand and forearm caused by a puncture injury to the first web space of the hand. Our objective is to increase awareness of the potential for seemingly minor trauma to cause entrapment of significant air in subcutaneous tissues, thereby decreasing the likelihood that a clinically benign-appearing patient will be started down an unnecessarily aggressive treatment pathway. A 16-year-old, otherwise healthy white female, presented to the pediatric emergency room with an impressive amount of subcutaneous emphysema that developed over a 12-h period after sustaining an accidental laceration to the first web space of her right hand. She appeared nontoxic and had a clinically benign presentation. A comprehensive work-up was performed. She was splinted by the orthopedic surgery resident on call, and was admitted to the Pediatric Intensive Care Unit for overnight monitoring. She received tetanus vaccination and broad-spectrum antibiotics. The patient was discharged 2 days after admittance, with a splint applied to her right hand and forearm. She undertook home-based physical and occupational therapy. She had a pain-free range-of-motion in the right wrist, elbow and shoulder. The swelling in the right hand subsided completely. Although initially alarming, traumatic subcutaneous emphysema in an otherwise healthy patient from minor wounds (as featured in this case) does not necessarily mean one ought to proceed down an aggressive treatment algorithm. Careful evaluation of the patient's history, clinical examination findings, and determination of the Laboratory Risk Indicator for Necrotizing Fasciitis score can help guide physicians in the management of traumatic subcutaneous emphysema and potentially avoid unnecessary and costly interventions.
format Online
Article
Text
id pubmed-9751530
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-97515302022-12-16 Traumatic subcutaneous emphysema of the hand/forearm: A case report Saela, Stephen Decilveo, Alexander Isaac, Roman Patel, Deepak V. Chin J Traumatol Case Report Subcutaneous emphysema is commonly associated with infection caused by gas-producing organisms. In this case report, we describe a rare instance of traumatic subcutaneous emphysema of the hand and forearm caused by a puncture injury to the first web space of the hand. Our objective is to increase awareness of the potential for seemingly minor trauma to cause entrapment of significant air in subcutaneous tissues, thereby decreasing the likelihood that a clinically benign-appearing patient will be started down an unnecessarily aggressive treatment pathway. A 16-year-old, otherwise healthy white female, presented to the pediatric emergency room with an impressive amount of subcutaneous emphysema that developed over a 12-h period after sustaining an accidental laceration to the first web space of her right hand. She appeared nontoxic and had a clinically benign presentation. A comprehensive work-up was performed. She was splinted by the orthopedic surgery resident on call, and was admitted to the Pediatric Intensive Care Unit for overnight monitoring. She received tetanus vaccination and broad-spectrum antibiotics. The patient was discharged 2 days after admittance, with a splint applied to her right hand and forearm. She undertook home-based physical and occupational therapy. She had a pain-free range-of-motion in the right wrist, elbow and shoulder. The swelling in the right hand subsided completely. Although initially alarming, traumatic subcutaneous emphysema in an otherwise healthy patient from minor wounds (as featured in this case) does not necessarily mean one ought to proceed down an aggressive treatment algorithm. Careful evaluation of the patient's history, clinical examination findings, and determination of the Laboratory Risk Indicator for Necrotizing Fasciitis score can help guide physicians in the management of traumatic subcutaneous emphysema and potentially avoid unnecessary and costly interventions. Elsevier 2022-11 2022-04-04 /pmc/articles/PMC9751530/ /pubmed/35450804 http://dx.doi.org/10.1016/j.cjtee.2022.04.001 Text en © 2022 Chinese Medical Association. Production and hosting by Elsevier B.V. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Saela, Stephen
Decilveo, Alexander
Isaac, Roman
Patel, Deepak V.
Traumatic subcutaneous emphysema of the hand/forearm: A case report
title Traumatic subcutaneous emphysema of the hand/forearm: A case report
title_full Traumatic subcutaneous emphysema of the hand/forearm: A case report
title_fullStr Traumatic subcutaneous emphysema of the hand/forearm: A case report
title_full_unstemmed Traumatic subcutaneous emphysema of the hand/forearm: A case report
title_short Traumatic subcutaneous emphysema of the hand/forearm: A case report
title_sort traumatic subcutaneous emphysema of the hand/forearm: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9751530/
https://www.ncbi.nlm.nih.gov/pubmed/35450804
http://dx.doi.org/10.1016/j.cjtee.2022.04.001
work_keys_str_mv AT saelastephen traumaticsubcutaneousemphysemaofthehandforearmacasereport
AT decilveoalexander traumaticsubcutaneousemphysemaofthehandforearmacasereport
AT isaacroman traumaticsubcutaneousemphysemaofthehandforearmacasereport
AT pateldeepakv traumaticsubcutaneousemphysemaofthehandforearmacasereport