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Previous Volume 342:740 March 9, 2000 Number 10 Next

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To the Editor: The medical mystery in the January 20 issue¹ involved a 79-year-old woman who presented to the emergency department with a several-hour history of facial swelling (Figure 1A). She had chronic obstructive pulmonary disease. The swelling of her head and neck had developed and progressed in a few hours, despite antihistamine and glucocorticoid treatment. She had fallen on her left side two days before admission. Physical examination revealed massive symmetric subcutaneous emphysema that involved the whole upper part of the body and the arms, extending to the fingernails. A chest film (Figure 1B) and . . . [Full Text of this Article]

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