Grossly delayed massive subcutaneous emphysema following laparoscopic left hemicolectomy: A case report

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Complications

Background:

• Surgical emphysema is a recognized complication of laparoscopic procedures, particularly in upper gastrointestinal and gynecological surgeries.
• This report presents the first documented case of delayed subcutaneous emphysema following a laparoscopic left hemicolectomy.

Purpose of the Study:

• To report the first case of delayed massive subcutaneous surgical emphysema after laparoscopic colorectal surgery.
• To discuss the conservative management and spontaneous resolution of this rare complication.

Main Methods:

• A 52-year-old female patient underwent a laparoscopic left hemicolectomy for sigmoid malignancy.
• Postoperatively, she developed massive subcutaneous emphysema and pneumoperitoneum, managed conservatively.
• Diagnostic imaging and enema confirmed no pneumothorax or anastomotic leak.

Main Results:

• The patient developed delayed massive subcutaneous emphysema on postoperative day 3.
• The emphysema resolved spontaneously by postoperative day 6.
• No anastomotic leak or pneumothorax was identified.

Conclusions:

• Delayed massive subcutaneous surgical emphysema is a rare complication of laparoscopic colorectal surgery.
• Conservative management can lead to favorable outcomes for this condition.
• The exact etiology of delayed emphysema in this context remains unexplained after excluding common causes.