Usually  when we hear or see the word, emphysema, our first thoughts go to the  lung condition that is a result of cigarette smoking and often a  precursor to lung cancer.

Subcutaneous emphysema may actually be defined as:

Subcutaneous - under the skin

Emphysema - air pocket

Therefore subcutaneous emphysema is air pockets under the skin. Often the condition is just called sub-cu.

There  are various causes for sub-cu, but in my case it is a result of lung  biopsy surgery coupled with a dual-tubed bronchoscopy. This is actually  the least most common cause of sub-cu.

When  doing the biopsy, there was an incision made into the lung wall. This  created a hole which allowed the air from the lung to be pushed out into  the pleura sac which surrounds the lung. The procedure resulted in a  pneumothorax or collapsed lung. The air that escaped then made its way  throughout my body and primarily noticeable in my neck and face giving  me the puffer or blow fish look.

For  years people have said I was full of it because of my brown eyes. Now  with the sub-cu, people can claim I am also full of hot air.

The  sub-cu in my situation is not necessarily dangerous, but needs  monitored for awhile, which is why I am now in day 12 of my current  hospital stay. Eventually the sub-cu will just be absorbed into my  body...but until then there will be some discomfort, the bloated look  and the sound of crispies crunching under the skin.

As  the lung incision heals, the lung will begin to seal itself off and  expand. Once the lung begins to expand, the need for a tube to help  drain off the leakage both liquid and air will become less needed. After  surgery I had three tubes in my right side. Within 36 hours two of  those tubes were able to be removed. The lone tube left may be in me for  awhile until the incision is completely healed. In the meantime, I get  the pleasure of sub-cu.

Sub-cu is a rare condition. When it does occur, possible causes include:

    Collapsed lung (pneumothorax), often occurring with a rib fracture
    Facial bone fracture
    Ruptured bronchial tube
    Ruptured esophagus

This condition can happen due to:

    Blunt trauma
    Forceful vomiting" (Boerhaave's syndrome)
    Gun shot wounds
    Stabbing
    Rarely after medical procedures such as endoscopy, a central venous line, intubation, and bronchoscopy

Air can also be found in between skin layers on the arms and legs or torso during certain infections, including gas gangrene.

http://nlm.nih.gov/medlineplus/ency/article/003286.htm

So  while sub-cu is slightly discerting to view and does provide a certan  amount of discomfort, if monitored properly, there is nothing to worry  about.

From the Cornfield, I may be full of it and be nothing but hot air right now...but this too shall pass.