Subcutaneous emphysema is a known complication of chest drains. Clinically it presents with extreme discomfort, anxiety or upper airway obstruction. 

It is known to occur with prolonged drainage, tube blockage, side port migration or poor tube placement. Incidence is more when multiple drains are in place. 

Usually self limiting and managed conservatively. 

Rarely intervention may be required and multiple techniques like infraclavicular blow holes, subcutaneous pig tail or large bore drains may be tried.