Mikhail Shady, Mina George, Wray Alisa, Matonis Danielle
University of California, Los Angeles Medical Center, Department of Internal Medicine, Los Angeles, CA.
University of California, Los Angeles Medical Center, Department of Anesthesia, Los Angeles, CA.
J Educ Teach Emerg Med. 2025 Jul 31;10(3):V8-V12. doi: 10.21980/J83W8H. eCollection 2025 Jul.
Subcutaneous emphysema (SE) is a rare but significant complication following dental procedures characterized by the presence of air in the subcutaneous tissue. This case report presents a 67-year-old male who developed right-sided facial swelling after tooth extraction, a procedure executed with high-power dental tools. Clinical findings included facial swelling and crepitus with no lip involvement, differentiating SE from an allergic reaction and hematoma. Diagnostic imaging through computed tomography (CT) and chest X-ray confirmed SE, showing diffuse subcutaneous air in facial and neck soft tissues. Initial management in the emergency department (ED) involved administration of antihistamines, corticosteroids, antibiotics, and otolaryngology (ENT) consultation with close monitoring for airway compromise. This case underscores the importance of including SE in differential diagnoses for post-dental procedure swelling, the effectiveness of CT imaging in SE identification, and the importance of early detection and treatment to prevent severe complications like respiratory and cardiac issues.
Subcutaneous emphysema; facial swelling; computed tomography (CT); dental procedure; emergency medicine.
皮下气肿(SE)是牙科手术后一种罕见但严重的并发症,其特征是皮下组织中存在空气。本病例报告介绍了一名67岁男性,在拔牙后出现右侧面部肿胀,该拔牙手术使用了高功率牙科工具。临床检查结果包括面部肿胀和捻发音,唇部未受累,这将皮下气肿与过敏反应和血肿区分开来。通过计算机断层扫描(CT)和胸部X光进行的诊断性成像证实了皮下气肿,显示面部和颈部软组织中有弥漫性皮下气体。急诊科(ED)的初始处理包括给予抗组胺药、皮质类固醇、抗生素,并咨询耳鼻喉科(ENT),同时密切监测气道是否受损。本病例强调了在牙科手术后肿胀的鉴别诊断中纳入皮下气肿的重要性、CT成像在皮下气肿识别中的有效性,以及早期检测和治疗以预防呼吸和心脏问题等严重并发症的重要性。
皮下气肿;面部肿胀;计算机断层扫描(CT);牙科手术;急诊医学。