Abstract
Subcutaneous emphysema is a rare feature caused by traumatism (weapons, accidents: crashes, barotrauma, …), dental care and infections. A 48-year-old woman consults for a right oral mucosa lesion and benefits from a biopsy for anatomopathological diagnosis. Within hours of the biopsy, bilateral jugal then cervical swelling has occured without signs of severity. The examination at 48 hours and the CT scan showed a bilateral cervicofacial emphysema with a spontaneous favorable resolution in a few days making the diagnosis of benign subcutaneous emphysema (BSCE). BSE can occurs after an endobuccal biopsy, a close follow up is necessary to rule out gas gangrene.The resolution is spontaneous with the necessity to reassure the patient.
Highlights
A 48-year-old patient was referred for consultation for gingival pain with xerostomia
Given the patient’s neoplastic medical history, she was sent to the emergency room for a CT scan of the head (Fig. 1) and neck (Figs. 2 and 3) to rule out any serious conditions and to confirm the iatrogenic origin following the biopsy of this benign, subcutaneous emphysema
The difficulty with diagnosing the onset of subcutaneous emphysema is to first eliminate gas gangrene as a possible underlying cause. Certain signs favor this diagnosis such as: sharp pain on palpation, purplish erythema, a foul odor, and even septic shock in the most severe cases. This explains why antibiotic therapy is empirically prescribed in the treatment of these benign, subcutaneous emphysemas
Summary
A 48-year-old patient was referred for consultation for gingival pain with xerostomia. A few hours later, the patient underwent oral surgery following the appearance of a subcutaneous emphysema starting in the supra-clavicular cavities and extending bilaterally up to the right and left jugular regions. A bilateral, subclavicular, subcutaneous crepitus was discovered which extended to the jugular regions
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