Massive Subcutaneous Emphysema, Pneumothorax and Pneumoscrotum: Diagnostic Dilemma on Autopsy

Background: subcutaneous emphysema is when gas or air in the layer under the skin. it literally means trapped air in the tissues beneath skin. it has characteristic crackling feel to touch, a sensation that has been described as similar to touching to rice krispies; this sensations under skin is called as subcutaneous crepitation.case report: a 50-years old male sustained injuries allegedly as a result of vehicular accident and was taken to a nearby private hospital. he was intubated there and then referred to a tertiary care hospital. he succumbed to death during transportation and was declared as brought dead on arrival. his body was brought for autopsy.conclusion: there was massive subcutaneous emphysema, pneumothorax and pneumoscrotum. their origin created a dilemma on autopsy due to various reasons. it is discussed in detail and tried to track the origin.