Dissecting aneurysm as a differential diagnosis for subcutaneous emphysema

When subcutaneous emphysema occurs as a complication of a painful tooth extraction [1] the differential diagnosis should include dissecting aneurysm of the aorta (DAA). The rationale is that severe pain is capable, not only of generating high trans pulmonary pressure, thereby causing subcutaneous emphysema [1], but also capable of generating an abrupt rise in blood pressure (BP) [2]. An abrupt increase in BP can, in turn, precipitate DAA in various contexts such as recreational drug abuse [3,4] and sexual arousal [5], and, arguably, also after painful tooth extraction.

Source: The American Journal of Emergency Medicine - March 5, 2020 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research