Ruptured Air Sac - Subcutaneous Emphysema


BYC Staff
Project Manager
Premium Feather Member
11 Years
Jun 24, 2012
The Golden State
Hi everyone, day before yesterday I found a little cockerel standing off by himself. At first, I thought he probably had coccidiosis, so I picked him up and brought him inside to start treatment. Closer inspection revealed a ruptured air sac (subcutaneous emphysema).

"What is Air Sac Rupture?
The accumulation of air under the skin of a bird looks like an oversized inflated balloon and affects their respiratory system. The cause of this condition is usually a tear in one of the air sacs and your veterinarian will show you how you can handle this if it reoccurs. Birds don't breathe the same way humans do, they don't have a diaphragm that moves the air in and out. The air sacs fill and empty in two cycles as they take each breath. Therefore, it is important to treat your bird immediately to enable efficient breathing.

Birds are unique; they have several air sacs located in their body which if ruptured, leads to an accumulation of air under their skin.

Symptoms of Air Sac Rupture in Birds
  • Large balloon shaped lump under their skin that can vary in size
  • In some birds, the balloon shape can blow up to almost grotesque shape within a matter of just a few hours
  • A brittle sound may be produced when touching the swollen bump
  • The swollen area feels soft and spongy when prodded
  • The ballooning skin looks very transparent and thin
There are two types of air sacs within your bird's body that are distinguished by their connection and position within your bird.
  • The pulmonary system is widespread within your bird's body with usually five large pairs although that depends on the species of bird and its flying characteristics
  • The nasopharyngeal or tympanic system of air sacs occur only in the head of birds including the occipital and frontal bones, and is connected or inter-relates to the nasal cavity
  • Air sacs vary between the breed of the bird, and is an integral part of its flying capabilities
Causes of Air Sac Rupture in Birds
  • The underlying cause is not known and is hard to define but knowing how to deal with this condition is important
  • If this condition is reoccurring often in your bird's life, it is important that you know how to treat it yourself, and your veterinarian can teach you to perform a simple but effective method of overcoming this
  • It is gas or air that has escaped from the air sacs caused by a rupture that allows the air to accumulate under the skin and this air needs to be released
  • A rupture can occur by your bird being startled at night, or if it flies into a window

Diagnosis of Air Sac Rupture in Birds
When your bird first experiences a rupture to one of its air sacs and develops a ballooning lump, it is important to take your bird to your avian veterinarian to have your bird checked. The obvious balloon shape, the transparent skin over the air lump, and your bird's discomfort will lead to a diagnosis of a ruptured air sac. A CT Scan can be done if in doubt. If your bird has just a small lump, it may just self-heal by itself, but if the lump is large it can interfere with your bird's eating and can press against internal organs, causing other problems. For the first time this happens, you will learn from your specialist how to manage this condition, and your bird will be given a full examination just to check his overall health and ensure there are no underlying diseases that are the cause.

Any type of bird can develop this condition, from budgerigars to large macaw parrots. Even pigeons and other wild birds can suffer this condition especially if they have survived an attack from a hawk or other predator, they may have their air sac damaged during the attack. IF you find a wild bird in this condition, inform the local wildlife officials. Inexperienced handling may further damage the bird, or the experts may be able to instruct you over the phone on how to safely assist the bird.

Treatment of Air Sac Rupture in Birds
Treatment for this condition is fairly simple and effective. Your veterinarian will disinfect around the skin area, and then he will carefully push a sterile needle into the skin above the air to allow the air to escape. Don’t be surprised if the area almost immediately fills with air again, as it may continue to do so after several repeated attempts to push out the air. Once the pressure is off, any remaining air will be slowly absorbed into your bird’s system without harm. Surgical repair or antibiotic treatment may be necessary but your specialist will be able to advise you on that.

It is hard to know whether this will be just a once off event, some birds can tend to have this happen on a regular basis. If this happens with your bird, your veterinarian will teach you how to do this air release process yourself, keeping in mind that any equipment you use must be sterilized always to prevent infection. Sometimes it may be many months before it ever happens again, sometimes it could reoccur within a month. Once the problem is solved, your bird will carry on with its life as per normal.

Recovery of Air Sac Rupture in Birds
Once your bird has been treated for an air sac rupture, and the ballooning effect is gone, it will recover remarkably well and continue with its normal life pattern. The air sac in birds seems to repair itself almost within a day or two, and if treated immediately, you can prevent the tear from enlarging. Management is required if the condition becomes a regular occurrence, as it can for some birds.

It is unknown why some birds are more prone to air sac ruptures, but if you are comfortable with treating your own bird, learning from your avian specialist how to give immediate relief will be of great benefit to your pet. Keep in mind that skin and equipment needs to be sterile before anything to prevent infection that may be crippling. Rapid treatment produces excellent recovery results."


"Subcutaneous emphysema is a common presentation affecting avian species. This condition occurs when tissue overlying an air sac is compromised and allows for direct communication to the subcutaneous space. Although not life-threatening in most cases, it can cause discomfort to the avian patient and affect the bird’s quality of life, immune status, and, in the case of wildlife, to prevent disease. A Teflon stent has been advocated as a means to reduce the buildup of air under the skin of chronic avian subcutaneous emphysema cases. In the case presented here, a Teflon stent was used as a temporary treatment modality until the underlying muscle layers healed. One month after placement, the stent was removed. The bird recovered with no evidence of subcutaneous emphysema and was eventually released."

Good video:

Other Ruptured Air Sac - Subcutaneous Emphysema links on BYC:
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Here he is today post slicing. I decided to use a scalpel blade instead of a needle because I had a feeling a needle hole would close up too quickly. I made the cut on the left first, but for some reason that did not release all of the air. Once I made the cut on the right all of the air released. So, my suggestion should anyone have to deal with this would be to use a scalpel, not a needle, and when cutting, pick an area of the skin without big blood vessels.

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I had a silkie x chick earlier this year that had one. I had iv catheters available to me, nice big 14g ones, and that was remarkably effective, since once the stylette was out, I could advance or withdraw the end and move it around a bit to get the air out without too much tissue damage - and the larger gauge was a larger hole for air to come out of. Too bad I couldn’t figure out some way to keep it in situ for a day or 2, it would’ve saved me poking the poor guy multiple times. His was abdominal and gave him a huge bubble butt around his right leg. It resolved well enough, no harm done. Not sure what happened to him either, I received him like that. 🤷🏼‍♀️ His took close to a couple of weeks to fully resolve. Wish I had taken pics but didn’t think of it at the time.
I don’t know if he ever had another, he was an awful little tyrant that I rehomed quickly. 🤣 last I heard he was the head of a bachelor flock.
If you ever have another, try slicing instead of poking. The last one I did I tried poking with a 14 gauge needle but that healed too quickly and it kept filling back up.

@casportpony, did this affect your cockerel’s mobility at all? I have a young pullet (8 weeks) that has this right now. She isn’t quite as big as your guy, but is close. I have attempted to release the air using a 20g needle, and I have a 16g one,l that I was going to try next, but reading your post I will use a blade tomorrow.

Once you cut him and deflated him did it refill? And if so, how many times did you have to deflate him before it resolved and air no longer escaped?

Did he have any issues walking? My girl is having mobility issues, and I’m starting to think she took a hard landing off the roosting bar, which is quite high for the babies (it’s about 30” off the ground). I have 20, 8-week old chicks and they crowd on there and she may have gotten pushed off, resulting in a leg injury and ruptured air sack.

Anyway, any insight you can offer would be much appreciated!!

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