Surgical emphysema

Surgical emphysema. This patient developed a large air leak following a right thoracotomy, and developed hugely extensive surgical emphysema despite the presence of a large bore chest tube (arrows). Air can dissect some distance along the soft tissues, and is often encountered in the neck and abdominal wall, and occasionally extends as far as the scrotum. Surgical emphysema is a useful sign in radiography, as it is often present in patients who have a traumatic pneumothorax, may actually be more obvious than the pneumothorax itself if it is small, and may therefore draw your attention to a pneumothorax which might otherwise have been overlooked.