title: Subcutaneous emphysema and mediastinitis: unusual complications of tonsillectomy.
abstract: BACKGROUND
  Subcutaneous emphysema and mediastinitis are rarely reported complications of tonsillectomy.
  
  
  METHODS
  We describe two patients who developed subcutaneous emphysema, one of them with mediastinitis, within a few days after tonsillectomy. The diagnosis was based on the clinical presentation and confirmed by computed tomography (CT). For the patient without mediastinitis, the emphysema disappeared after a short period of reintubation and administration of antibiotics. For the patient with mediastinitis, surgical drainage of a cervico-mediastinal purulent collection was necessary to obtain healing.
  
  
  CONCLUSIONS
  The events leading to subcutaneous emphysema and mediastinitis have not been entirely clarified. They probably include direct introduction of air into the neck via either the tonsillar bed or a laryngeal or pharyngeal wound caused by intubation. The clinical presentation, treatment and possible pathophysiology of subcutaneous emphysema and medisastinits are discussed.
  
  
  CONCLUSIONS
  Emphysema and mediastinitis after tonsillectomy occur seldomly. If rapidly recognised and appropriately managed, mortality can be avoided.
authors.affiliation: Department of Otorhinolaryngology, CHU Liège.
authors.forename: C
authors.initials: C
authors.lastname: Gillot
authors.forename: S
authors.initials: S
authors.lastname: Tombu
authors.forename: V
authors.initials: V
authors.lastname: Crestani
authors.forename: P
authors.initials: P
authors.lastname: Huvelle
authors.forename: P
authors.initials: P
authors.lastname: Moreau
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003131:Combined Modality Therapy; D004322:Drainage / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008480:Mediastinitis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D008875:Middle Aged; D018570:Risk Assessment; D012720:Severity of Illness Index; D013352:Subcutaneous Emphysema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D014068:Tonsillectomy / Q000009:adverse effects* / Q000379:methods; D014069:Tonsillitis / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents