Subcutaneous Emphysema Presenting as Bilateral Periorbital Angioedema
A 73-year-old man presented to the emergency department after waking with acute, bilateral, painless periorbital swelling (Figure 1, A). Recent history was significant for a spontaneous left pneumothorax treated with intercostal catheter insertion 1 week prior. There was no history of previous food or drug allergies, recent new allergen exposure, or angiotensin-converting enzyme inhibitor use. Background was significant for a 40-pack-year smoking history and ischemic heart disease. Examination was negative for urticaria, lip or tongue angioedema, hypotension, and wheeze.