BMJ Case Reports 2018; doi:10.1136/bcr-2018-224380
  • Rare disease

Subcutaneous emphysema to the head and neck: an unlikely traumatic origin

  1. John Bizakis1
  1. 1 Department of Otolaryngology - Head and Neck Surgery, University Hospital of Larissa, Larissa, Greece
  2. 2 Department of General Surgery, University Hospital of Larissa, Larissa, Greece
  3. 3 Obstetrics and Gynaecology Department, University Hospital of Larissa, Larissa, Greece
  1. Correspondence to Ourania Koukoura, okoukoura{at}
  • Accepted 29 May 2018
  • Published 8 June 2018


Subcutaneous emphysema to the neck represents a rare entity mainly derived from iatrogenic and traumatic origin. We report a case of a subcutaneous emphysema resulted from an intraoral injury aiming to emphasise the significance of precise medical history to identify an unlikely mechanism. A 40-year-old female patient was presented with subcutaneous emphysema extending from the region underneath the left eye up to the submandibular area of the neck. The patient complained of painful, swollen neck. The patient mentioned that the symptoms began after an intraoral injury accidentally caused by the use of a high-pressure water jet device meant for car wash. The patient was managed conservatively and was discharged after 2 days. This case highlights the urgency for clinical suspicion for unlikely mechanisms. Moreover, the manufacturer companies should alert and give official warning for the contingency of injury due to incorrect or careless usage.


  • Contributors JH: surgeon and writing. ES: writing and editing. OK: editing. JB: supervision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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