Subcutaneous emphysema and pneumomediastinum after endotracheal anaesthesia.
BACKGROUND
We report a case of subcutaneous emphysema and pneumomediastinum that presented postoperatively after tracheal extubation.


METHODS
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.


METHODS
He was treated conservatively with bed rest, oxygen, analgesia, antibiotic prophylaxis, reassurance and close monitoring.


RESULTS
The patient made an uneventful recovery.


CONCLUSIONS
We discussed the possible causes.
Chiu
C L
CL
Department of Anaesthesia, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Ong
G S
GS
D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008478:Mediastinal Emphysema / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008875:Middle Aged; D013352:Subcutaneous Emphysema / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy