title: Subcutaneous emphysema in the lower extremities-always an emergency? Complications from minimally invasive surgery-a case report.
abstract: BACKGROUND
  Lower-extremity subcutaneous emphysema is an unusual presentation in the emergency department, and it is often associated with gas-forming bacterial infections that confer significant morbidity and mortality. Because the presence of subcutaneous emphysema in an extremity can be alarming, physicians often pursue aggressive diagnostic and therapeutic strategies to identify and treat the underlying cause. In some cases, however, subcutaneous emphysema does not represent a life-threatening medical condition. The source of the subcutaneous air may not always be immediately recognized and can lead to either over- or under-utilization of resources to direct patient care.
  
  
  METHODS
  We describe a case of bilateral lower-extremity subcutaneous emphysema after recent robotic surgery. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: As the role of minimally invasive surgery and the push for shorter hospitalizations continue to rise, we are likely to see an increase in patients with complications from such procedures in the emergency department setting. Familiarity with the potential complications of these procedures is essential to differentiating between life-threatening and non-life-threatening conditions.
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: McLennan
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Cedric W
authors.initials: CW
authors.lastname: Lefebvre
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D035002:Lower Extremity; D011183:Postoperative Complications / Q000209:etiology*; D065287:Robotic Surgical Procedures / Q000009:adverse effects*; D013352:Subcutaneous Emphysema / Q000209:etiology*
keywords: lower-extremity emphysema; minimally invasive surgery; postoperative complication; robotic surgery; subcutaneous emphysema