title: Late presentation of subcutaneous emphysema and pneumomediastinum following elective tonsillectomy.
abstract: Subcutaneous emphysema and pneumomediastinum are rare complications following elective tonsillectomy. Although the mechanism of injury is unclear, air is thought to enter through either the buccopharyngeal mucosa during surgery or via alveolar rupture during positive pressure ventilation. Patients typically present immediately after surgery or upon anesthesia emergence. We describe a case of delayed pneumomediastinum in a 30year-old female who presented 4days after surgery. With only one other case described, we review the literature and remind the reader to be cognizant of this late complication.
authors.affiliation: Major, Medical Corps, US Army; Department of Otolaryngology; Tripler Army Medical Center; Honolulu, Hawaii. Electronic address: daniel.d.tran.mil@mail.mil.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Tran
authors.affiliation: Lieutenant Colonel, Medical Corps, US Army; Chief, Otology/Neurotology; Tripler Army Medical Center; Honolulu, Hawaii.
authors.forename: Philip D
authors.initials: PD
authors.lastname: Littlefield
mesh_terms: D000328:Adult; D002908:Chronic Disease; D057210:Delayed Diagnosis; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy; D013902:Radiography, Thoracic / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D013352:Subcutaneous Emphysema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D014068:Tonsillectomy / Q000009:adverse effects* / Q000379:methods; D014069:Tonsillitis / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome