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Subcutaneous emphysema and pneumomediastinum after endotracheal anaesthesia
1Department of Anaesthesia, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Introduction:
We report a case of subcutaneous emphysema and pneumomediastinum that presented postoperatively after tracheal extubation.
Clinical Picture:
A 51-year-old man had an uneventful anaesthesia lasting about 6.5 hours. Intubation was performed by a very junior medical officer and was considered difficult. He developed sore throat, chest pain, numbness of both hands and palpable crepitus around the neck postoperatively. Chest X-ray revealed diffuse subcutaneous emphysema, pneumomediastinum and possible pneumopericardium.
Treatment:
He was treated conservatively with bed rest, oxygen, analgesia, antibiotic prophylaxis, reassurance and close monitoring.
Outcome:
The patient made an uneventful recovery.
Conclusions:
We discussed the possible causes.