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Subcutaneous emphysema is a condition characterized by air accumulation in the subcutaneous tissue, often presenting as soft swellings in the chest wall. It may be associated with underlying issues such as fractured ribs, pneumothorax, pleural effusion, and pneumonia. The presence of air bronchograms and opaque hemithorax may indicate complications like atelectasis or lung malignancy. Proper diagnosis and timely intervention are crucial to address potential complications, including chronic empyema and lung abscess.
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pneumonia • The hemithorax is opaque and there is no shift of the heart or trachea There may be an air bronchogram sign present
atelectasis • Atelectasis of an entire lung = loss of volume of the affected lung • Visceral and parietal pleura do NOT separate from each other • There is a shift of heart and hemidiaphragm toward side of opacification (toward side of volume loss)
Effusion • an effusion (whatever the fluid is) fills the entire hemithorax • It acts like a mass • Pushing the heart and trachea away from the side of opacification
Postpneumonectomy • When the entire lung is removed, there is volume loss on the pneumonectomized side • The hemithorax eventually fibroses and becomes opaque • Clues: There is frequently a resected fifth rib and/or surgical clips
