The Development of Extensive Subcutaneous Emphysema Following Robotic Total Abdominal Colectomy Due to Lynch Syndrome: A Case Report.
| Autor: | Garcia A; Anesthesiology, HCA Florida Westside Hospital, Plantation, USA., Irvine DS; Osteopathic Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Davie, USA., Tomasello L; Anesthesiology, HCA Florida Westside Hospital, Plantation, USA., Thornton I; Anesthesiology and Critical Care, HCA Florida Westside Hospital, Plantation, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2024 Mar 27; Vol. 16 (3), pp. e57069. Date of Electronic Publication: 2024 Mar 27 (Print Publication: 2024). |
| DOI: | 10.7759/cureus.57069 |
| Abstrakt: | Subcutaneous emphysema, the presence of air in the subcutaneous layer of the skin, is a possible result of surgical, infectious, or spontaneous etiologies. Although usually self-limiting, the development of subcutaneous emphysema in the perioperative period has been associated with delayed extubation and the development of complications such as pneumomediastinum, pneumoperitoneum, and pneumothorax and can worsen clinical outcomes in these patients. Here, we report the case of a 57-year-old male patient who presented to the operating room (OR) for a robotic total colectomy due to Lynch syndrome. The procedure was complicated by the development of diffuse, severe subcutaneous emphysema, which was recognized by palpable crepitus and obscuration of anatomical landmarks during an attempted transversus abdominis plane (TAP) block for pain control prior to patient extubation. The decision was made to leave the patient intubated and managed postoperatively in the ICU, where radiographic and computerized tomography (CT) scans confirmed the severity of subcutaneous emphysema. Hemodynamic and respiratory status were managed in the ICU and on postoperative day 3 the patient passed an endotracheal cuff leak test and was extubated. The patient was transferred to a surgical step-down on postoperative day 7 and following the resolution of ileus and acute kidney injury (AKI), he was discharged from the hospital on postoperative day 17. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Garcia et al.) |
| Databáze: | MEDLINE |
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