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Subcutaneous emphysema can be caused by medical procedures and medical conditions that cause the pressure in the alveoli of the lung to be higher than that in the tissues outside of them. Its most common causes are pneumothorax and a chest tube that has become occluded by a blood clot or fibrinous material.
These cases result in usually painless swelling of the face and neck, with an immediate onset, the crepitus (crunching sound) typical of subcutaneous emphysema, and often with subcutaneous air visible on X-ray. One of the main causes of subcutaneous emphysema, along with pneumothorax, is an improperly functioning chest tube.