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Traumatic Subcutaneous Emphysema From Helium

Edwin L. Kaplan, MD; Mauvine Reed Barnes, MD
JAMA. 1967;202(2):153. doi:10.1001/jama.1967.03130150121034.
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To the Editor:—  Subcutaneous emphysema is usually related to a defect in the respiratory tract, either associated with a pneumothorax or following interstitial emphysema of the lung. It is also known to occur after dental extractions or drilling of teeth with high-speed air-turbine equipment, and after numerous operative and traumatic episodes. The purpose of this letter is to report subcutaneous emphysema and ischemia of the toes following trauma to the foot.

Report of a Case:—  A 25-year-old woman was admitted to the hospital on March 18, 1966. While working barefooted at a fete, she incurred a painful injury to her right foot when an opened cylinder of helium fell upon it. The nozzle struck her right great toe, broke the skin, and discharged its gas subcutaneously for several seconds; fullness of both legs (Fig 1) and the abdominal wall followed. Her right great toe was cool, pale, swollen, and anesthetic


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