[A case of severe subcutaneous emphysema during laparoscopic right-hemicolectomy]

A 76-year-old woman, weighing 40 kg, was scheduled for laparoscopic right-hemicolectomy. Forty minutes after starting the laparoscopic procedure, PaCO2 increased to 64.3 mmHg. Massive subcutaneous emphysema from the anterior thorax to the abdomen was noted and we stopped the laparoscopic procedure. In the laparoscopic procedure for the treatment of colectomy, it is important to discover abnormalities such as snowball crepitation and arrhythmia, and to monitor ETCO2 continuously in order to avoid massive subcutaneous emphysema and hypercapnia. During a laparoscopic procedure, hypercapnia might cause acidosis, arrhythmia, hypotension, myocardial ischemia, and cardiac arrest.