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下肢皮下气肿——总是一种急症吗?微创手术并发症——病例报告。

Subcutaneous emphysema in the lower extremities-always an emergency? Complications from minimally invasive surgery-a case report.

作者信息

McLennan Ryan J, Lefebvre Cedric W

机构信息

Wake Forest School of Medicine, Winston-Salem, North Carolina.

出版信息

J Emerg Med. 2015 Feb;48(2):e31-3. doi: 10.1016/j.jemermed.2014.10.001. Epub 2014 Nov 20.

Abstract

BACKGROUND

Lower-extremity subcutaneous emphysema is an unusual presentation in the emergency department, and it is often associated with gas-forming bacterial infections that confer significant morbidity and mortality. Because the presence of subcutaneous emphysema in an extremity can be alarming, physicians often pursue aggressive diagnostic and therapeutic strategies to identify and treat the underlying cause. In some cases, however, subcutaneous emphysema does not represent a life-threatening medical condition. The source of the subcutaneous air may not always be immediately recognized and can lead to either over- or under-utilization of resources to direct patient care.

CASE REPORT

We describe a case of bilateral lower-extremity subcutaneous emphysema after recent robotic surgery. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: As the role of minimally invasive surgery and the push for shorter hospitalizations continue to rise, we are likely to see an increase in patients with complications from such procedures in the emergency department setting. Familiarity with the potential complications of these procedures is essential to differentiating between life-threatening and non-life-threatening conditions.

摘要

背景

下肢皮下气肿在急诊科是一种不常见的表现,它常与产气细菌感染相关,可导致严重的发病率和死亡率。由于肢体出现皮下气肿可能令人担忧,医生通常会采取积极的诊断和治疗策略来识别和治疗潜在病因。然而,在某些情况下,皮下气肿并不代表危及生命的病症。皮下气体的来源可能并不总是能立即被识别,这可能导致在指导患者护理时资源的过度或不足利用。

病例报告

我们描述了一例近期机器人手术后双侧下肢皮下气肿的病例。急诊科医生为何应了解此情况?:随着微创手术的作用不断增加以及缩短住院时间的趋势持续上升,我们可能会在急诊科看到此类手术并发症患者的数量增加。熟悉这些手术的潜在并发症对于区分危及生命和非危及生命的情况至关重要。

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