Traumatic subcutaneous emphysema following blood donation: A case report

Transfusion. 2024 Mar;64(3):550-553. doi: 10.1111/trf.17762. Epub 2024 Feb 21.

Abstract

Background: Subcutaneous emphysema is a condition where air becomes trapped under the skin, typically resulting from surgery or skin trauma. It is mostly localized and its occurrence in blood donors is exceedingly rare. Phlebotomy poses minimal risk of subcutaneous emphysema, but procedural errors may lead to such complications.

Study design and method: This is a case report of 29-year-old repeat blood donor who experienced subcutaneous emphysema following blood donation. The donor was vigorously squeezing sponge ball during donation resulting in displacement of the needle which required readjustment. Post-donation, the donor reported a crackling sensation and mild swelling near phlebotomy site. Non-contrast computed tomography (NCCT) scans confirmed subcutaneous emphysema, attributing its development to air trapping in subcutaneous plane due to ball valve mechanism.

Results: Computed tomography (CT) imaging revealed subcutaneous emphysematous changes in the right cubital region and no evidence of hematoma. The swelling spontaneously subsided in 10-12 days without any intervention. The case underscores the importance of differentiating subcutaneous emphysema from common complications like hematoma.

Discussion: Subcutaneous emphysema in blood donors is exceptionally rare but should be managed with clear communication. Donors should be reassured that the condition, although rare, is benign and self-resolving. Healthcare providers should be equipped to handle such rare complications, offering appropriate care and documenting incidents for future prevention.

Keywords: adverse donor reactions; donors; surgical emphysema; transfusion service operations.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blood Donation*
  • Blood Donors
  • Hematoma / complications
  • Humans
  • Subcutaneous Emphysema* / diagnostic imaging
  • Subcutaneous Emphysema* / etiology
  • Tomography, X-Ray Computed / adverse effects