Surgical emphysema (summary)

Dr Jeremy Jones et al.

Surgical emphysema (or subcutaneous emphysema) occurs when air/gas is located in the subcutaneous tissues (the layer under the skin). This usually occurs in the chest, face or neck.

Reference article

This is a summary article; read more in our article on surgical emphysema.

  • pathophysiology
    • gas within the soft tissues
    • causes
      • tracheobronchial perforation with gas tracking
      • penetrating trauma
  • investigation
    • chest x-ray
      • gas within the soft tissues
      • can be easy to see in the neck and upper chest
      • can have very strange appearance with overlying structures
    • CT chest
      • much more readily demonstrated on a CT
Plain radiograph


Radiolucent striations may be seen outlining pectoralis major, especially if the surgical emphysema is located in anterior chest wall (sometimes called the ginkgo leaf sign). This is due to air surrounding the muscle fibre bundles.

CT chest

Pockets of air located seen as dark areas located in the subcutaneous space of area affected.​

Medical student radiology curriculum
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Article Information

rID: 31298
System: Chest
Synonyms or Alternate Spellings:

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Cases and Figures

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    Case 1: surgical emphysema
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    Case 2: post-traumatic surgical emphysema
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    Case 3: spontaneous air everywhere
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