Tiong W H C, Butt F S
Department of Plastic and Reconstructive Surgery, Cork University Hospital, Cork, Ireland.
J Plast Reconstr Aesthet Surg. 2009 Feb;62(2):e29-32. doi: 10.1016/j.bjps.2007.11.002.
Noninfective subcutaneous emphysema of the upper extremity, albeit rare, has to be borne in mind when treating patients with subcutaneous emphysema. The misdiagnosis of this condition as its serious infective counterpart often leads to unnecessary aggressive treatment. Noninfective subcutaneous emphysema often accompanies a patient who has no systemic symptoms of illness. Unfortunately, the distinction is not always easy especially when history of injury suggests involvement of an infective or reactive element. Penetrating blackthorn injury is common, especially in rural communities, and often occurs from farming or gardening activities. Blackthorn penetration can cause numerous tissue reactions once embedded under the skin and they are often contaminated with soil. Here we present, for the first time, a case where penetrating blackthorn injury to the wrist resulted in noninfective subcutaneous emphysema involving the whole upper limb and neck, and its subsequent management.
上肢非感染性皮下气肿虽罕见，但在治疗皮下气肿患者时必须予以考虑。将这种情况误诊为严重的感染性疾病往往会导致不必要的积极治疗。非感染性皮下气肿常伴随没有全身疾病症状的患者出现。不幸的是，这种区分并不总是容易，尤其是当损伤史提示存在感染或反应性因素时。黑刺李刺伤很常见，尤其是在农村社区，常发生于农耕或园艺活动中。黑刺李刺入皮肤后可引起多种组织反应，且常被土壤污染。在此，我们首次报告一例因手腕部黑刺李刺伤导致累及整个上肢和颈部的非感染性皮下气肿及其后续治疗的病例。
