title: Grossly delayed massive subcutaneous emphysema following laparoscopic left hemicolectomy: A case report.
abstract: BACKGROUND
  Surgical emphysema is a known early complication of laparoscopic surgery, common during upper gastrointestinal and gynaecological surgery; the authors present the first case of delayed subcutaneous emphysema following a laparoscopic left hemicolectomy.
  
  
  METHODS
  A 52-year-old woman underwent a laparoscopic left hemicolectomy for a sigmoid malignancy; on the third post-operative day after an uneventful procedure, she developed a massive surgical emphysema involving her face, neck and chest with associated pneumoperitoneum but without any evidence of pneumothorax. A gastrograffin enema ruled out an anastomotic leak. Apart from a borderline tachycardia, mildly low saturations and an area of erythema in her right flank, she was totally asymptomatic. The emphysema resolved spontaneously around the 6th post-operative day.
  
  
  CONCLUSIONS
  Massive subcutaneous surgical emphysema after laparoscopic colorectal surgery is a rare complication and can me managed conservatively with a good outcome.
  
  
  CONCLUSIONS
  To our knowledge, this represents the first case of delayed massive surgical emphysema following colorectal surgery, the aetiology of which has still not been clearly explained, after exclusion of the most common causes.
authors.affiliation: Department of General Surgery, Raigmore Hospital, Old Perth Road, Inverness IV2 3UJ, United Kingdom.
authors.forename: Angharad
authors.initials: A
authors.lastname: Jones
authors.affiliation: Department of General Surgery, Raigmore Hospital, Old Perth Road, Inverness IV2 3UJ, United Kingdom.
authors.forename: Umberto
authors.initials: U
authors.lastname: Pisano
authors.affiliation: Department of General Surgery, Raigmore Hospital, Old Perth Road, Inverness IV2 3UJ, United Kingdom.
authors.forename: Sherif
authors.initials: S
authors.lastname: Elsobky
authors.affiliation: Department of General Surgery, Raigmore Hospital, Old Perth Road, Inverness IV2 3UJ, United Kingdom. Electronic address: angus.watson@nhs.net.
authors.forename: Angus J M
authors.initials: AJ
authors.lastname: Watson
keywords: Complication; Delayed; Hypercarbia; Laparoscopic colectomy; Surgical emphysema