Piotrowski Sławomir, Jesikiewicz Dominika
Oddział Otolaryngologiczny Szpitala Miejskiego im. Brudzińskiego w Gdyni.
Otolaryngol Pol. 2009 Nov-Dec;63(6):528-31. doi: 10.1016/S0030-6657(09)70174-X.
Authors present the case of a 6 years old boy with rare complication of mediastinal emphysema after tonsilloadenotomy.
Authors detailed describe the evolution of this complication and methods of its treatment. This complication was treated in Child's Surgery Clinic where the digestive and respiratory tracts were controlled and upper mediastinotomy with drainage of the mediastinum was performed. Subsequently, the child was treated on the Intensive Care Unit where prolonged intubation and parenteral feeding were used and was discharged completely healed after 7 days. Authors discuss possible causes of this complication as a result of injury of the pharyngeal wall during the operation due to vomits after general anastesia. RESULTS OF THE TREATMENT: Total period of treatment of this complication was 14 days. The authors deal as well with the issue of underestimating the risk associated with the operational procedures on tonsils, especially in the case of children. They also consider the possibility of performing such procedures in the one day surgery conditions.
The analysed complication associated with tonsils operation are rather unusual and its successfull treatment depends on quick and accurate diagnosis, which is possible due to meticulous postoperational care.
作者介绍了一名6岁男孩在扁桃体腺样体切除术后发生罕见纵隔气肿并发症的病例。
作者详细描述了该并发症的发展过程及其治疗方法。此并发症在儿童外科诊所进行治疗，对消化道和呼吸道进行了监测，并实施了上纵隔切开术及纵隔引流。随后，患儿在重症监护病房接受治疗，采用了长时间插管和肠外营养，7天后完全康复出院。作者讨论了该并发症可能的病因，认为是全身麻醉后呕吐导致手术过程中咽壁受伤所致。治疗结果：该并发症的总治疗期为14天。作者还探讨了低估扁桃体手术相关风险的问题，尤其是在儿童病例中。他们还考虑了在日间手术条件下进行此类手术的可能性。
所分析的与扁桃体手术相关的并发症相当罕见，其成功治疗取决于快速准确的诊断，而这得益于细致的术后护理。
