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Subcutaneous Emphysema
Other Names: Ruptured Air Sac, Windpuff
Subcutaneous emphysema, sometimes referred to as air sac rupture or "windpuff", is the accumulation of air under the skin. It usually occurs resulting from an injury or defect in the air sacs, lungs or trachea where air escapes the respiratory system.
A less common cause is associated with a skin wound and infection with anaerobic bacteria (referred to as gangrenous dermatitis). In this case, the tissue is discolored (black, green, or red) and the bird appears very sick.
Case 1: in a A 28 week old rooster was discovered with respiratory difficulties, gas accumulation under the skin and wasn't eating for 4 days. He was brought to the National Veterinary School of Tunisia where he was diagnosed with subcutaneous emphysema. The examination revealed he had pale mucous membranes, puffy areas all over his body, and weight loss. Palpating the areas weren't painful and there was no sign of trauma or skin break. Radiographs confirmed their diagnosis as they showed large transparent zones in his head, neck and right flank. Treatment consisted of puncture of the areas with gas accumulation with a sterile hypodermic needle followed by a course of IM injections of 25 mg/kg of tetracycline for 3 days to prevent bacterial complications and further gas entry. Ref
Case 2: in a Chicken A 6-month-old male bantam fowl was presented to Veterinary Clinical Complex, Bhoiguda, C.V.Sc., P.V.N.R.T.V.U., Hyderabad with history of anorexia, staggering gait, reduced activity and swelling under the right wing for 2 days. On palpation, the swelling (between right wing and leg) was pale, soft, balloon-like with no pain. It was tentatively diagnosed as subcutaneous emphysema of unknown etiology. On day 1 and 2, a sterile hypodermic needle was used to puncture the skin to extract the accumulated air under aseptic conditions. There was recurrence of emphysema the next day in the same area. On 3rd day after extraction of air, benzathine penicillin was injected into the affected area. There was no recurrence of emphysema thereafter. Benzathine penicillin was injected into the affected area for the next 2 consecutive days. The bird was given B-complex injection for all 5 days. The bird recovered uneventfully without any further complications. Based on the response of bird to the treatment, it was concluded that the case was subcutaneous emphysema of bacterial origin. Ref
Case 3: in a Parrot A 17-month-old parrot had been admitted to the hospital with the symptoms of a swollen abdomen, anorexia, and coughing. Based on the clinical history and physical examination, the diagnosis was made. The problem was treated with a single needle puncture and supportive treatment. On that day, the bird was released, and until it was extricated, there was continuous contact with the owners. It can be confirmed by radiography or by removing the gas from the enlarged area. This condition can be treated with paracentesis and supportive care, with or without the use of antibiotics. Ref
Isolate the bird from the flock and place in a safe, comfortable, warm location (your own chicken "intensive care unit") with easy access to water and food. Limit stress. Call your veterinarian.
Puncturing the skin with a sterile hypodermic needle to extract the air followed by a course of antibiotics
K Kaboudi 2019
Surgery
Suturing in a double-layer closure first of the thickened air sac tissue, followed by the subcutaneous layer with 5-0 polydioxanone.
G Browning et al., 2019
Teflon stent
Used in chronic cases to reduce buildup of air under the skin.
