1/10. subcutaneous emphysema and pneumomediastinum after endotracheal anaesthesia.INTRODUCTION: We report a case of subcutaneous emphysema and pneumomediastinum that presented postoperatively after tracheal extubation. CLINICAL PICTURE: A 51-year-old man had an uneventful anaesthesia lasting about 6.5 hours. intubation was performed by a very junior medical officer and was considered difficult. He developed sore throat, chest pain, numbness of both hands and palpable crepitus around the neck postoperatively. Chest X-ray revealed diffuse subcutaneous emphysema, pneumomediastinum and possible pneumopericardium. TREATMENT: He was treated conservatively with bed rest, oxygen, analgesia, antibiotic prophylaxis, reassurance and close monitoring. OUTCOME: The patient made an uneventful recovery. CONCLUSIONS: We discussed the possible causes.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/10. Massive subcutaneous emphysema following routine endotracheal intubation.Upper aerodigestive tract injury after endotracheal intubation is a rare but serious complication. The case of a 57-year-old female, who developed extensive neck and pneumomediastinum following a knee arthroscopy under general anaesthesia, is presented. Possible mechanisms of injury and management options are discussed.- - - - - - - - - - ranking = 0.2keywords = anaesthesia (Clic here for more details about this article) |
3/10. Pneumomediastinum in labour -- probably not caused by a lumbar epidural anaesthesia.We describe a case of pneumomediastinum and subcutaneous emphysema during labour. The patient had previously received an epidural anaesthesia to alleviate labour pain. We found several reports of subcutaneous emphysema and pneumomediastinum (or pneumothorax) possibly caused by or related to epidural anaesthesia use, but conclude that the epidural anaesthesia was probably not a cause in our case.- - - - - - - - - - ranking = 1.4keywords = anaesthesia (Clic here for more details about this article) |
4/10. Spontaneous pneumomediastinum in 3rd trimester of pregnancy.A 25-year-old primiparous woman in her third trimester (36. week) of pregnancy presented with spontaneous pneumomediastinum and cervical subcutaneous emphysema. The patient's symptoms were completely resolved after 2 weeks of supportive management. A Caesarean section was performed in 40. week under general anaesthesia resulting in the birth of a healthy infant. Spontaneous pneumomediastinum is very rare and generally dangerous for a pregnant woman and infant.- - - - - - - - - - ranking = 0.2keywords = anaesthesia (Clic here for more details about this article) |
5/10. diabetes mellitus and Fournier's gangrene.A case is described in which Fournier's gangrene was the presenting feature of diabetes mellitus and in which extensive subcutaneous emphysema prevented the use of spinal anaesthesia for debridement. In the literature four cases have been reported in which Fournier's gangrene was the presenting feature in patients with diabetic ketoacidosis. Diabetes may predispose to a form of Fournier's gangrene in which subcutaneous gas formation is marked, though subcutaneous emphysema to the degree described in this case has not previously been reported in this condition. diabetes mellitus and subcutaneous emphysema must be sought in patients with Fournier's gangrene as both may have a profound influence on management.- - - - - - - - - - ranking = 0.2keywords = anaesthesia (Clic here for more details about this article) |
6/10. Subcutaneous facial emphysema complicating dental anaesthesia.A 20 year-old female developed swelling and protrusions of the tongue and marked facial swelling while under general anaesthesia for dental restoration and gigivectomy. The initial diagnosis was angioedema; however x-rays showed marked subcutaneous emphysema more extensive in the perimandibular area with a minimal amount in the neck. There was no evidence of pneumomediastinum or pneumothorax. The iatrogenic subcutaneous emphysema was felt to be due to air-driven dental equipment. Tracheal intubation was maintained for 21 hours to prevent airway obstruction. The patient was treated with oxygen and antibiotics. subcutaneous emphysema may occur following root canal therapy, tooth extraction, periodontal surgery and operative dentistry, due to the use of air-driven dental equipment. It has the potential to cause obstruction.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
7/10. Laparoscopic extraperitoneal inguinal hernia repair complicated by subcutaneous emphysema.The case of a healthy 59-yr-old man who underwent elective laparoscopic extraperitoneal inguinal hernia repair and general anaesthesia is presented. After one hour of surgery, a sudden increase in the FETCO2 from 5.0% to 9.4% in relation to a massive subcutaneous emphysema, but without any haemodynamic instability, was noticed. The acute rise of FETCO2 was the first sign of an abnormal event. Nevertheless, subcutaneous emphysema was diagnosed with chest wall examination and palpation. subcutaneous emphysema and hypercarbia are potential complications of laparoscopic surgery, but are more likely to occur in extraperitoneal surgery, since insufflated CO2 can diffuse easily into the surrounding tissues. High insufflation pressures will increase chances of this occurring and was the most likely cause of this complication. This case encouraged us to make recommendations for the management of laparoscopic extraperitoneal surgery which included: monitoring of CO2 insufflation pressure, routine examination and palpation of chest wall, use of N2O with caution, adjusting ventilation to physiological FETCO2 and excluding other causes of subcutaneous emphysema and hypercarbia.- - - - - - - - - - ranking = 0.2keywords = anaesthesia (Clic here for more details about this article) |
8/10. Respiratory acidosis and subcutaneous emphysema during laparoscopic cholecystectomy.A case is presented of a healthy 69-year-old woman who underwent elective laparoscopic cholecystectomy under general anaesthesia. As surgery proceeded she developed hypercapnia (arterial blood PaCO2 = 100 mmHg) and a related respiratory acidosis (arterial blood pH 7.07). The cause was attributed to subcutaneous insufflation and absorption of CO2, directly related to the surgical pneumoperitoneum.- - - - - - - - - - ranking = 0.2keywords = anaesthesia (Clic here for more details about this article) |
9/10. Surgical emphysema and upper airway obstruction complicating recovery from anaesthesia.We describe a case of surgical emphysema and life-threatening airway obstruction resulting from a small pharyngeal perforation. The perforation apparently resulted from the use of a Yankauer-type sucker after uneventful anaesthesia for stapedectomy.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
10/10. subcutaneous emphysema in labour.Spontaneous subcutaneous and mediastinal emphysema is a rare but potentially dangerous complication of labour. The condition was observed in an 18-year-old primigravida in the first stage of labour, who subsequently required Caesarean section which was performed under epidural anaesthesia.- - - - - - - - - - ranking = 0.2keywords = anaesthesia (Clic here for more details about this article) |
| | Next -> |