Extensive subcutaneous emphysema

Case contributed by Dr Matt Adams

Presentation

Inpatient with new haematuria. Reason for being an inpatient withheld.

Patient Data

Age: 75 years
Gender: Male
Ultrasound

Urinary tract ultrasound

Diffuse echogenicity superficially across the abdominal wall with posterior dirty shadowing, consistent with gas in the subcutaneous tissues.

Redundant study in assessing the renal tract due to lack of sonographic visualization of the renal tract.

X-ray

Chest radiograph

Known extensive subcutaneous emphysema, left upper lobe mass and left-sided pneumothorax requiring two left-sided chest drains with the superior one kinked.

Extensive subcutaneous emphysema is consistent with the ultrasound findings.

Case Discussion

This study highlights the importance of understanding the limitations of study modalities. In this case, the fact that ultrasound pulses will not transmit through extensive subcutaneous emphysema due to the high reflective sonographic index between gas and soft tissue.

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Case information

rID: 70640
Published: 29th Aug 2019
Last edited: 29th Aug 2019
System: Chest
Inclusion in quiz mode: Included
Institution: Waikato Hospial

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