Generalized Surgical Emphysema in Open Pelvic Fracture: a case report

Paudel, Byapak; Pandey, Chakra Raj

doi:10.3126/noaj.v3i1.9323

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“…Non traumatic emphysema may be due to pathological changes in respiratory tract [2]. Generalized surgical emphysema has been reported following maxillofacial trauma, rib fracture [3], open pelvic fracture [4], laparoscopic surgery [5], cricothyrotomy, pulmonectomy, thoracotomy [6] and positive pressure ventilation. One of the rare complications of maxillofacial surgical procedures is malignant subcutaneous emphysema.…”

Section: Introductionmentioning

confidence: 99%

Early Postoperative Malignant Subcutaneous Emphysema: Report and Review

Sahoo¹,

Singh²,

Roy³

et al. 2016

J. Maxillofac. Oral Surg.

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Background Subcutaneous emphysema is defined as presence of air or gas in subcutaneous tissue layer. It may be localized or generalized due to various aetiological factors. Although SE and pneumomediastinum are selflimiting conditions, life-threatening complications may develop. Escape of air into both pleural cavity causing bilateral pneumothorax and tension pneumothorax can be termed as malignant emphysema. Purpose To report a case of malignant generalized subcutaneous emphysema in early postoperative phase following palatoplasty. Case Report A 25 year old female patient was operated for closure of residual oronasal communication using an anteriorly based tongue flap. The patient was reversed from general anesthesia and shifted to the post-operative room with the endotracheal tube in situ. Sudden swelling of the face and periorbital area was noticed which spread all over the body. A diagnosis of malignant post-operative subcutaneous emphysema was made and the patient was shifted back to the operation theatre. She was managed successfully by bilateral tube thoracotomy and tracheostomy.Conclusion Close observation of the patient in early postoperative stage having endotracheal tube in situ is crucial to avoid such complication. Regardless of aetiology, early recognition of the clinical features of tension pneumothorax and timely intervention are necessary for the survival of the patient.

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Section: Introductionmentioning

confidence: 99%