Jinekolojik Laparoskopik Cerrahi Sırasında Masif Cilt Altı Amfizem

Abstract

Massive subcutaneous emphysema is a rare complication in laparoscopic surgery. Complications such as insufflation, pneumothorax, pneumomediastinum to the preperitoneal area during pneumoperitoneum have also been reported in laparoscopic surgery. A 32-year-old woman was admitted for laparoscopic cystectomy because of right ovarian cyst. The end-tidal carbon dioxide values of the patient started to increase (end-tidalCO₂:49mmHg) 20 minutes after starting CO₂ insufflation (P:15mmHg). Subcutaneous emphysema was detected in face and neck, eyelids and PaCO₂ was 59mmHg. Patient was extubated after positive pressure ventilation. Emphysemia in the face area including the eyelid continued in the 12th hour of the patient's emphysema completely regressed. Prolonged surgery, CO₂ gas insufflation pressure ≥15mmHg, 6 or more trocar access, older age may reduce subcutaneous resistance and causes emphysema. In our case, we would like to highlight to massive subcutaneous emphysema.