Pneumatic-induced subcutaneous emphysema of the upper limb: a case report and literature review.

INTRODUCTION AND

IMPORTANCE

Pneumatic-induced subcutaneous emphysema (SE) of the upper limb is a rare occupational injury often mistaken for serious infectious conditions. This case highlights the importance of accurate diagnosis and conservative management, contributing valuable insight to surgical and medical literature.

CASE PRESENTATION: We report the case of a 37-year-old man who presented with left upper limb swelling and crepitus after injury with a pneumatic blower tip. Clinical examination revealed a puncture wound with palpable subcutaneous air, stable vital signs, and no systemic symptoms. Laboratory findings were unremarkable, and radiographs confirmed subcutaneous air confined to the soft tissues. The patient was managed conservatively with observation, limb immobilization, and prophylactic antibiotics, leading to full recovery.

CLINICAL DISCUSSION: Noninfectious SE secondary to pneumatic injury can mimic necrotizing infections, leading to potential overtreatment. Early recognition using clinical assessment and imaging is essential to guide appropriate management and avoid unnecessary surgery.

CONCLUSION

Pneumatic-induced SE should be considered in patients with upper limb swelling post-exposure to compressed air. Conservative treatment is effective in stable patients without signs of infection or compartment syndrome. Clinician awareness can prevent unnecessary interventions and improve patient outcomes.