Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2023; 11(9): 2110-2115
Published online Mar 26, 2023. doi: 10.12998/wjcc.v11.i9.2110
Successful treatment of a rare subcutaneous emphysema after a blow-out fracture surgery using needle aspiration: A case report
Ha-Jong Nam, Syeo-Young Wee
Ha-Jong Nam, Syeo-Young Wee, Department of Plastic and Reconstructive Surgery, Soonchunhyang University Gumi Hospital, Gumi-si 39371, Gyeonsangbuk-do, South Korea
Author contributions: Nam HJ contributed to manuscript writing and visualization and data collection; Wee SY contributed to conceptualization and methodology and project administration and manuscript review and editing, and supervision; all authors have read and approved the final manuscript.
Supported by Soonchunhyang research fund, No. 2023-0024.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Syeo-Young Wee, MD, PhD, Doctor, Professor, Department of Plastic and Reconstructive Surgery, Soonchunhyang University Gumi Hospital, 1 Gongdan-ro 179, Gumi-si 39371, Gyeonsangbuk-do, South Korea.
Received: January 13, 2023
Peer-review started: January 13, 2023
First decision: January 30, 2023
Revised: February 1, 2023
Accepted: February 27, 2023
Article in press: February 27, 2023
Published online: March 26, 2023

Many cases of emphysema associated with blow-out fractures occur before surgery due to trauma. However, emphysema can occur even after surgery, and most of such cases are managed conservatively and allowed to resolve. Swelling in the periorbital area due to emphysema that occurs after surgery can make early recovery difficult.


Herein, we describe a case of postoperative subcutaneous emphysema that was treated using a simple needle aspiration method. A 48-year-old male patient visited the hospital with a blow-out fracture of the left medial orbital wall and nasal bone fracture. One day postoperatively, swelling and crepitus in the left periorbital area were observed, and follow-up computed tomography showed emphysema in the left periorbital subcutaneous area. Needle aspiration using an 18-gauge needle and syringe was used to relieve the emphysema. The symptoms of sudden swelling improved immediately, and no recurrence was observed.


We conclude that needle aspiration is a useful method that could help in relieving symptom, resolving discomfort, and enabling early return to daily life in patients with postoperative subcutaneous emphysema.

Keywords: Blow out fracture, Subcutaneous emphysemas, Mechanical aspiration, Case report

Core Tip: A cases of postoperative subcutaneous emphysema is relatively rare. Though orbital emphysema is usually self-limited, we report a case report of postoperative subcutaneous emphysema that treated with a simple method using immediate needle aspiration to relieve discomfort and enable recovery to daily life.