Severe Iatrogenic Subcutaneous Emphysema After Thoracic Surgery: CT Scan Diagnosis, Radiology Interpretation, and Emergency Management Guide
Introduction A patient develops sudden swelling of the chest wall, neck fullness, crackling skin, and respiratory discomfort after thoracic surgery. A chest radiograph is ordered urgently. What appears to be harmless soft-tissue air may actually signal an evolving postoperative complication requiring immediate evaluation. This is the clinical reality of iatrogenic subcutaneous emphysema —air trapped within subcutaneous tissues due to a medical procedure, surgery, chest tube placement, or airway intervention. While often self-limited, severe cases may indicate persistent pneumothorax, bronchopleural fistula, tracheobronchial injury, or inadequate thoracic drainage. In modern medical imaging , especially MRI, CT scan diagnosis pathways (with CT preferred here), early recognition is essential. Accurate radiology interpretation can distinguish benign postoperative air from dangerous expanding emphysema requiring urgent action. This article reviews the condition using a real p...