Emphysema

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ΕΤΥΜΟΛΟΓΙΑ

From Greek emphysan. en meaning 'in' and physan meaning 'to blow' (derived from physa meaning breath or blast). Its original use may have referred to subcutaneous emphysema, but it was first used to describe expanded lung airspaces in 1721 by the Dutch anatomist, Frederick Ruysch.

Emphysema in its widest sense means abnormal distension of a body tissues by air. Please see pulmonary emphysema for the main article on the commonest use of the term. The term is used however in many other contexts and even out of true meaning in specific medical terms as a root word when the gas is actually generated by fermentation as in emphysematous pyelonephritis or emphysematous cystitis.

Contents

Pulmonary emphysema

  • A common pulmonary pathology characterised by irreversible expansion of the alveoli and/or by the destruction of alveolar walls. This is the usual meaning of emphysema when unqualified.

Subcutaneous emphysema

  • Distension of subcutaneous tissues by air. This will usually be secondary to trauma, such as a chest wound, rib fracture with lung trauma, a complication of tapping a pneumothorax or undertaking a intrathoracic biopsy. It may also occur during parturition (accounting for a large proportion of mediastinal emphysema in young adults) and is more common in "Crack" cocaine smokers and in cannabis users.
  • Cutaneous emphysema is likely to be actually subcutaneous emphysema but technically high pressure air injection into the dermis could cause it

In head and neck emphysema, inspect the pharyngeal mucosa for a breach.

Interstitial emphysema

  • should be qualified by the organ concerned eg:
    • Pulmonary interstitial emphysema
      • Persistent interstitial pulmonary emphysema (PIPE) - air-leakage in the perivascular tissues of the lung, primarily affecting mechanically ventilated neonates
    • Interstitial emphysema of colon

Congenital lobar emphysema

Emphysema of bone is termed bone pneumatization.