Laparoscopic surgery-associated massive subcutaneous emphysema requiring mechanical ventilation in a patient with endometriosis: a case report.
Laparoscopic surgery-associated massive subcutaneous emphysema requiring mechanical ventilation in a patient with endometriosis: a case report.
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DOI：
10.1093/jscr/rjac110
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发表时间：
2022-03
影响因子：
0.5
通讯作者：
Yoshida Y
中科院分区：
文献类型：
--
作者：
Tsuyoshi H;Inoue D;Miyazaki Y;Kawamura H;Onuma T;Kurokawa T;Yoshida Y
虽然皮下气肿是腹腔镜手术常见的良性并发症，但咽部气肿延伸至颈部时可导致气道阻塞。在此，我们报告一例51岁的子宫内膜异位症和严重粘连患者在腹腔镜全子宫切除术和双侧输卵管卵巢切除术中出现皮下气肿延伸至颈部，需要机械通气。尽管尚未建立手术或疾病特异性风险分层，但子宫内膜异位症引起的严重粘连和手术引起的大量腹膜缺损可能导致皮下组织脆弱，从而导致大量皮下气肿。这项研究强调了术前风险评估的重要性，除了术中和术后监测通气障碍和皮下气肿。
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.