Laparoscopic surgery-associated massive subcutaneous emphysema requiring mechanical ventilation in a patient with endometriosis: a case report

Abstract

Although subcutaneous emphysema is a common benign complication of laparoscopic surgery, airway obstruction can occur due to pharyngeal emphysema when it extends to the neck. Here, we report a case of subcutaneous emphysema extending to the neck that required mechanical ventilation in a 51-year-old patient with endometriosis and severe adhesions during total laparoscopic hysterectomy and bilateral salpingo-oophorectomy. Although surgical or disease-specific risk stratification has not yet been established, the severe adhesions due to endometriosis and massive peritoneal defect due to the procedure might lead to the fragility of the subcutaneous tissue, resulting in a massive subcutaneous emphysema. This study highlights the importance of preoperative risk assessment in addition to intraoperative and postoperative monitoring for ventilation disorders and subcutaneous emphysema.

Broad subcutaneous emphysema with airway obstruction during robot‐assisted partial nephrectomy: A case report and literature review

“…To date, seven cases of severe subcutaneous emphysema accompanied by airway obstruction have been reported. 9 , 10 , 11 , 12 Apart from one case, all of these had either pharyngeal or laryngeal edema or emphysema.…”

“…Airway narrowing can be caused by physical compression secondary to emphysema around the trachea. To date, seven cases of severe subcutaneous emphysema accompanied by airway obstruction have been reported 9–12 . Apart from one case, all of these had either pharyngeal or laryngeal edema or emphysema.…”