title: Recurrent subcutaneous emphysema of the face: a challenging clinical problem.
abstract: In the neck or face, there are different causes for subcutaneous emphysema such as injury to the sinuses, the hypopharynx, the laryngotracheal complex, the pulmonary parenchyma, the esophagus or the presence of gas-forming organisms. However, factitious subcutaneous emphysema, a rare cause, must be considered in the differential diagnosis. In this clinical report, we discuss a 20-year-old girl who was under follow-up because of recurrent subcutaneous emphysema of the face and periorbital area. After 2 years of work-ups, including a period of close observation in the intensive care unit, self air injection by syringe was found as the cause of recurrent subcutaneous emphysema of the face, and the patient was labeled as having factitious recurrent subcutaneous emphysema. Therefore, when a patient presents with unexplained recurrent subcutaneous emphysema, one should suspect self-infliction and examine for puncture marks.
authors.affiliation: General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Hojjati
authors.forename: Sam Zeraatian Nejad
authors.initials: SZ
authors.lastname: Davani
authors.forename: Hamed Ghoddusi
authors.initials: HG
authors.lastname: Johari
mesh_terms: D000328:Adult; D000388:Air; D005145:Face / Q000000981:diagnostic imaging; D005162:Factitious Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D011859:Radiography; D012008:Recurrence; D013352:Subcutaneous Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*