Walter G, Welsch F, Hoffmann R
Abteilung für Septische Chirurgie, BG-Unfallklinik Frankfurt/Main, Friedberger Landstr. 430, 60389, Frankfurt/Main, Deutschland.
Unfallchirurg. 2012 Mar;115(3):226-33. doi: 10.1007/s00113-010-1870-0.
Soft-tissue emphysema following surgical procedures needs prompt and accurate diagnosis in order not to miss severe infections, such as clostridial myonecrosis and necrotizing fasciitis. We report the case of a 32-year-old patient who developed massive crepitation of the right leg and thoracic wall after knee arthroscopy had been performed a few days earlier. He was readmitted under suspicion of gas gangrene. This could not be ruled out by preoperative examinations as a subacute infection existed in the range of the infrapatellar incision. A mini-arthrotomy was carried out to exclude necrotizing soft tissue infection and to rinse the joint. An intercompartment emphysema could be confirmed intraoperatively. The postoperative course was uneventful. The main differential diagnoses of benign soft Tissue emphysema are summarized and treatment options are recommended.
外科手术后发生的软组织气肿需要及时准确的诊断，以免漏诊严重感染，如梭菌性肌坏死和坏死性筋膜炎。我们报告一例32岁患者的病例，该患者在几天前进行膝关节镜检查后，右腿和胸壁出现大量捻发音。他因疑似气性坏疽再次入院。由于髌下切口范围内存在亚急性感染，术前检查无法排除气性坏疽。进行了小切口关节切开术以排除坏死性软组织感染并冲洗关节。术中证实存在肌间室气肿。术后过程顺利。总结了良性软组织气肿的主要鉴别诊断并推荐了治疗方案。
