Rubio P A, Sharman T L, Farrell E M
Int Surg. 1982 Oct-Dec;67(4 Suppl):418-9.
A case of massive dissecting emphysema secondary to attempted emergency tracheostomy is reported. Malpositioning of the tube in the pretracheal fascia and positive pressure ventilation were the cause of the dissecting emphysema. This problem was recognized with subsequent removal of the tracheostomy tube, but unfortunately the skin was sutured which prevented air from escaping. The diagnosis was made by physical examination and chest roentgenogram. It was successfully treated by reopening of the wound and evacuation of clots. Careful technique performed under optimal conditions is of paramount importance in avoiding this complication.
报告了一例因急诊气管切开术操作失误继发的大面积纵隔气肿病例。气管导管置于气管前筋膜位置不当以及正压通气是导致纵隔气肿的原因。在随后拔除气管切开导管时发现了这个问题，但不幸的是皮肤已缝合，导致气体无法逸出。通过体格检查和胸部X线片做出诊断。通过重新打开伤口并清除血凝块成功治愈。在最佳条件下进行仔细操作对于避免这种并发症至关重要。
