[Iatrogenic cutaneous emphysema].
BACKGROUND
Tracheal perforation following orotracheal intubation is a rare but classic complication of general anaesthesia, and marked cutaneous emphysema can occur. We report a rare case of facial cutaneous emphysema revealed by swelling with pseudovesicles on the eyelids.


METHODS
A 99-year-old woman developed extensive facial swelling with pseudo-vesicles on the upper and lower eyelids following right hip replacement surgery. Swelling of the upper members and thoracic area was also seen. Chest X-rays showed marked cutaneous emphysema of the thoracic wall. Bronchial endoscopy revealed perforation of the posterior aspect of the trachea. The patient was presenting cutaneous emphysema as a result of post-intubation tracheal perforation.


CONCLUSIONS
We report a rare case of cutaneous emphysema in a 99-year-old woman after tracheal perforation following orotracheal intubation. The significant feature of our case report is the actual manifestation of the condition. Our patient developed swelling of the eyelid with pseudovesicles. When confronted with sudden onset of pseudovesicles of the eyelids after surgery, dermatologists must not misdiagnose cutaneous emphysema and must examine their patient carefully for other clinical signs. Bronchial endoscopy should be undertaken immediately to investigate for tracheal perforation.
Blanchard
E
E
Service de dermatologie, hôpital La Milétrie, CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers cedex, France. estelle-blanchard@orange.fr
Wierzbicka-Hainaut
E
E
Mallem
S
S
Chasseuil
P
P
Guillet
G
G
D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip; D005143:Eyelids; D005145:Face; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery; D006801:Humans; D007049:Iatrogenic Disease; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*; D008480:Mediastinitis / Q000517:prevention & control; D011183:Postoperative Complications / Q000209:etiology*; D011859:Radiography; D013352:Subcutaneous Emphysema / Q000175:diagnosis / Q000209:etiology*; D035441:Thoracic Wall; D014132:Trachea / Q000293:injuries*
D000900:Anti-Bacterial Agents