Emergency casebook
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Stab wounds to the thorax are seen in the emergency department and can be caused in a variety of ways. This case highlights an unusual cause of injury – a leather jacket with spikes on the back of it. This type of jacket is often worn by "Punks" as a fashion statement. We report that falling onto such a jacket may result in accidental thoracic injury leading to subcutaneous emphysema. A thorough clinical assessment is mandatory to exclude underlying lung injury or pneumothorax. In patients with subcutaneous emphysema and an otherwise normal chest x ray an in-hospital observation period of 24 hours, to observe for any delayed complications, is adequate if the patient remains clinically stable.
Kane N, Graudins A. "Punk" rock can be bad for you: a case of surgical emphysema from a "punk" rocker’s leather jacket. Emerg Med J 2006;23:e35. http://emjonline.com/cgi/content/full/23/6/e35 doi: 10.1136/emj.2005.033100
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