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Thorac Cardiovasc Surg 2014; 62(06): 531-534
DOI: 10.1055/s-0032-1322616
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Tension Subcutaneous Emphysema during Laparoscopic Surgery Treatment of Colon Cancer: A Case Report

J. S. Chea
1   Department of Anesthesiology and Intensive Care, St. Paul Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
,
S. M. Chae
1   Department of Anesthesiology and Intensive Care, St. Paul Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
,
S. W. Moon
2   Department of Thoracic and Cardiovascular Surgery, St. Paul Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Publication History

01 March 2012

05 June 2012

Publication Date:
24 November 2012 (online)

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Abstract

Carbon dioxide (CO2) insufflation is now essential for most endoscopic surgeries, such as abdominal, pelvic, and neck endoscopic surgery. It is not uncommon for CO2 leaks to occur unintentionally into subcutaneous tissue, later diffusing into a patient's bloodstream and resulting in hypercarbia. Regardless of the etiology of subcutaneous emphysema, a similar clinical management is required. Herein, we report on a case of tension subcutaneous emphysema and subsequent fatal ventilatory failure due to massive subcutaneous emphysema during laparoscopy. A timely blowhole incision is an effective intervention in an emergent setting like this case, although the patient had endotracheal intubation.

Keywords

tension subcutaneous emphysema - hypercarbia - blowhole incision
 

  • References

  • 1 Saggar VR, Singhal A, Singh K, Sharma B, Sarangi R. Factors influencing development of subcutaneous carbon dioxide emphysema in laparoscopic totally extraperitoneal inguinal hernia repair. J Laparoendosc Adv Surg Tech A 2008; 18 (2) 213-216
    CrossrefPubMedGoogle Scholar
  • 2 Williams JG. Malignant subcutaneous emphysema—a case report and discussion. Anaesth Intensive Care 1974; 2 (1) 69-72
    PubMedGoogle Scholar
  • 3 Eveloff SE, Donat WE, Aisenberg R, Braman SS. Pneumatic chest wall compression. A cause of respiratory failure from massive subcutaneous emphysema. Chest 1991; 99 (4) 1021-1023
    CrossrefPubMedGoogle Scholar
  • 4 Conetta R, Barman AA, Iakovou C, Masakayan RJ. Acute ventilatory failure from massive subcutaneous emphysema. Chest 1993; 104 (3) 978-980
    CrossrefPubMedGoogle Scholar
  • 5 Herlan DB, Landreneau RJ, Ferson PF. Massive spontaneous subcutaneous emphysema. Acute management with infraclavicular “blow holes.”. Chest 1992; 102 (2) 503-505
    CrossrefPubMedGoogle Scholar
  • 6 Sherif HM, Ott DA. The use of subcutaneous drains to manage subcutaneous emphysema. Tex Heart Inst J 1999; 26 (2) 129-131
    PubMedGoogle Scholar
  • 7 Gottlieb A, Sprung J, Zheng XM, Gagner M. Massive subcutaneous emphysema and severe hypercarbia in a patient during endoscopic transcervical parathyroidectomy using carbon dioxide insufflation. Anesth Analg 1997; 84 (5) 1154-1156
    PubMedGoogle Scholar