Tsuyoshi Hideaki, Inoue Daisuke, Miyazaki Yumiko, Kawamura Hiroshi, Onuma Toshimichi, Kurokawa Tetsuji, Yoshida Yoshio
Department of Obstetrics and Gynecology, University of Fukui, Fukui, Japan.
J Surg Case Rep. 2022 Mar 26;2022(3):rjac110. doi: 10.1093/jscr/rjac110. eCollection 2022 Mar.
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.
尽管皮下气肿是腹腔镜手术常见的良性并发症，但当它蔓延至颈部时，可因咽气肿导致气道梗阻。在此，我们报告一例皮下气肿蔓延至颈部的病例，该病例为一名51岁患有子宫内膜异位症且在全腹腔镜子宫切除术和双侧输卵管卵巢切除术中粘连严重的患者，需要进行机械通气。虽然尚未建立手术或疾病特异性风险分层，但子宫内膜异位症导致的严重粘连以及手术造成的大面积腹膜缺损可能导致皮下组织脆弱，从而引发大面积皮下气肿。本研究强调了除术中及术后监测通气障碍和皮下气肿外，术前风险评估的重要性。
