Recurrent factitious subcutaneous emphysema: report of a complex case in a young woman and a literature review

The Kaohsiung Journal of Medical Sciences
Yi-Pei Lee, Julia Yu-Yun Lee

Abstract

Subcutaneous emphysema (SE) can be caused by antecedent trauma, surgery, rupture of visceral organs or serious infection from gas-forming microorganisms. Factitious SE is very rare; only about a dozen cases have been reported. Most patients had an underlying psychiatric condition or relevant history. The diagnosis and management of factitious SE are challenging. We report a new case of factitious SE with a very complex clinical course. A 29-year-old woman was seen at consultation for recurrent attacks of painful soft tissue swelling, affecting her chest wall, abdomen and neck over several months. Factitious disease was suspected because of the negative medical history of identifiable visceral perforations or gas-forming infections and the presence of multiple bizarre linear scars on the arm. This was supported by finding multiple recent puncture marks on the neck, chest and upper extremities on close inspection. The patient's history was remarkable for multiple stressful events in her life, frequent job changes, substance abuse and suicide attempts. Psychiatric evaluation revealed adjustment disorder with depression and anxiety, cluster B personality with bipolar II disorder and substance abuse. During the 1-year period, she ha...Continue Reading

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Citations

Apr 26, 2015·The Journal of Hand Surgery·Jacob A MackSteven C Haase
Feb 7, 2015·The Journal of Emergency Medicine·Gabriel WardiAnthony J Medak
Nov 10, 2013·Orthopedics·John R FowlerAaron G Grand
Feb 25, 2018·Acta chirurgica Belgica·Lynn De RoeckFilip Thiessen

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