Department of Anesthesiology and Pain Medicine, Samsung Seoul Hospital, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Anesthesiol. 2012 May;62(5):488-92. doi: 10.4097/kjae.2012.62.5.488. Epub 2012 May 24.
We report a rare case of a 72-year-old female who developed extensive subcutaneous emphysema, bilateral pneumothoraces, pneumomediastinum, pneumoperitoneum, and pneumoretroperitoneum after a percutaneous dilatational tracheostomy. The patient's T-cannula was accidentally connected to the oxygen line with a non-perforated connector. The patient rapidly developed respiratory insufficiency and subcutaneous emphysema in the neck and both shoulders. The bilateral pneumothoraces were managed using a chest tube. CT scans of the chest, abdomen, and pelvis revealed an extensive distribution of air throughout the chest and abdomen. The patient was treated successfully with supportive care. This case illustrates the rare occurrence of air passing into multiple body compartments, highlighting the potentially serious complications of a tracheostomy and the importance of intensive care during the recovery period.
我们报告了一例罕见病例,一名 72 岁女性在行经皮扩张气管切开术后发生广泛皮下气肿、双侧气胸、纵隔气肿、气腹和腹膜后气肿。患者的 T 型管意外地与无穿孔连接器连接到氧气线上。患者迅速出现呼吸功能不全和颈部及双肩皮下气肿。双侧气胸采用胸腔引流管处理。胸部、腹部和骨盆的 CT 扫描显示空气广泛分布于胸部和腹部。患者经支持治疗成功治愈。该病例说明了空气进入多个体腔的罕见情况,突出了气管切开术的潜在严重并发症以及恢复期间加强护理的重要性。