Early Postoperative Malignant Subcutaneous Emphysema: Report and Review

Area of Science:

• Medicine
• Surgery
• Pulmonology

Background:

• Subcutaneous emphysema (SE) involves air in subcutaneous tissues, potentially leading to severe complications.
• Malignant emphysema, characterized by bilateral tension pneumothorax, is a critical condition.
• Palatoplasty carries risks, including rare but severe postoperative air entrapment.

Purpose of the Study:

• To present a case of malignant generalized subcutaneous emphysema.
• To highlight this complication in the early postoperative phase after palatoplasty.

Main Methods:

• A 25-year-old female underwent palatoplasty for oronasal defect closure.
• Postoperatively, rapid facial and generalized swelling indicated malignant SE.
• Management involved bilateral tube thoracotomy and tracheostomy.

Main Results:

• The patient developed sudden, widespread subcutaneous emphysema post-palatoplasty.
• Malignant generalized subcutaneous emphysema was diagnosed.
• Successful management was achieved through surgical intervention.

Conclusions:

• Close postoperative monitoring is essential, especially with an in-situ endotracheal tube.
• Early identification of tension pneumothorax signs is critical.
• Timely surgical intervention is necessary for survival in malignant SE cases.