title: The Diagnosis and Management of Patient with Delayed Symptoms from a Tracheal Tear.
abstract: Development of subcutaneous emphysema after gastrointestinal endoscopy with general anesthesia presents a diagnostic conundrum. We discuss the management of a patient who experienced significant vomiting followed by neck and facial swelling with crepitus and shortness of breath after the endoscopic retrograde cholangiopancreatography. The presence of respiratory distress usually suggests that head and neck subcutaneous emphysema is most likely associated with pneumothorax and/or pneumomediastinum. We discuss the prevention, differential diagnosis, and current management of tracheal tears including subcutaneous emphysema.
authors.affiliation: From the *Department of Anesthesiology and Pain Management, University of Texas Medical Center, Dallas, Texas; and †Department of Anesthesiology, Parkland Health and Hospital System, Dallas, Texas.
authors.forename: Nancy B
authors.initials: NB
authors.lastname: Greilich
authors.forename: Irina
authors.initials: I
authors.lastname: Gasanova
authors.forename: Brian
authors.initials: B
authors.lastname: Farrell
authors.forename: Girish P
authors.initials: GP
authors.lastname: Joshi
mesh_terms: D003937:Diagnosis, Differential; D019468:Disease Management; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects*; D005260:Female; D006801:Humans; D022125:Lacerations / Q000000981:diagnostic imaging* / Q000209:etiology; D008875:Middle Aged; D013352:Subcutaneous Emphysema / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000000981:diagnostic imaging / Q000293:injuries*