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Subcutaneous emphysema after open colorectal surgery without obvious cause

Behnam Sanei, Mohammad Hossein Sanei

CaseRepClinPractRev 2007; 8:94-97

ID: 476906

Published: 2007-03-30


Background: The term subcutaneous emphysema has been used, because air or gas is found within the soft tissue. It occurs in many situation including perforated viscus, Boerhaave syndrome, mechanical ventilation, drug abuse, paraquat intoxication, respiratory disease, laparoscopic surgery, infection with gas producing microorganisms, SMA syndrome, rectal barotrauma,
Munchausen’s syndrome, epidural anesthesia. We describe two cases of subcutaneous emphysema after open colorectal surgery.
Case Report: Two cases, a 43-year man and a 75-year old woman underwent laparatomy for volvulous and rectopexy respectively. A few days after operation subcutaneous emphysema were developed in the left side of abdominal wall. There was no infection in their incision site .we
performed contrast enema and CXR but we did not find any obvious cause for subcutaneous emphysema. We did not do chest CT scan in these patients. This complication resolved without additional surgical treatment and during two weeks, patients fully recovered with no signs of emphysema.
Conclusions: The etiology of subcutaneous emphysema in our patients is unclear. We think that the occult pnuemothorax, maybe a predisposing factor for this complication. This type of pnuemothorax is not revealed in routine CXR, so, we suggest to perform chest CT scan in this situation.

Keywords: Subcutaneous Emphysema, open abdominal surgery, complication



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