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Noticed swollen neck, chest pain, sore throat and difficulty in swallowing. Found subcutaneous emphysema on neck. Worrisome

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Internal Medicine Specialist
Practicing since : 2001
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I just found subcutaneous emphysema on the right side of my neck from just below my mastoid process down to the pit posterior to my clavicle. I discovered it about 3 hours ago and now re-checking and palpating it went away for the most part, but I am still feeling the signs and symptoms of swelling of the neck, neck and chest pain, sore throat, and difficulty swallowing. I'm wondering how long it would take for those symptoms to go away.
Also, I'm still not sure as to what the cause of the subcutaneous emphysema was but in taking a guess I might attribute it to my wisdom tooth growing in and occasionally puffing up and tightening my right cheek where the tooth is growing in to partially alleviate the pain by forcing the pressure to stretch the surrounding gums the tooth is breaking through. Is it possible that by doing this, in a Valsalva-like maneuver I can be forcing air through gingival and mucosal lacerations and eventually into the XXXXXXX fascial spaces of my neck? Also, in doing some research I read that subcutaneous emphysema can also be caused by facial fractures. I believe I may possibly have one somewhere around my right coronoid process from an impact sustained earlier in the year. Ever since then, when moving my jaw out anteriorly and moving it from left to right i can feel the difference with the left and right side specifically around my coronoid process. While my left side feels smooth, the right side feels almost as if it is grinding against something.
I'm hoping to get a doctor's opinion on what might possibly be going on, what might have possibly caused it, if i should just sleep it off or seek further medical attention. Do i need antibiotics incase it's a gas-releasing bacteria?Should I go to the ER for the chest pain or is it natural when associated with subcutaneous emphysema? What should I do??
Posted Mon, 19 Nov 2012 in Medicines and Side Effects
Answered by Dr. Ram Choudhary 3 hours later
Thanks for writing in to Healthcare Magic!
You should definitely go to ER and consult a physician, get a chest x XXXXXXX CBC and ABG done. How severe is pain, you may need pain killer. The subcutaneous emphysema is also called as surgical emphysema.
It can be caused by injury, procedures, pneumothorax, rupture of bullae in the lungs, facial fracture where it will develop in immediate following period and not after a year time as you are scared.
The troubling tooth also can not cause it.
Strong pressure due to Valsalva can result in a spontaneous bulla and can cause such a problem.
You need a general physical examination and investigation and need to be treated accordingly. You should be proactive because at times the sudden tension pneumothorax can develop[ and becomes life threatening issue.
Gas releasing bacteria thrive on devitalised tissues and I do not believe that is the case here. You can not keep waiting at home with this condition and must go to ER.
If you have any further query please let me know I would try to answer it for you.
Wish you a great health!
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