Korean J Anesthesiol.  1995 Dec;29(6):913-917. 10.4097/kjae.1995.29.6.913.

Pneumomediastinum and Subcutaneous Emphysema Complicating Tonsillectomy and Ademoidectomy

• Lee YJ
• Kang YI
• Hur CR
• Lee YS

• KMID: 2090952
• DOI: http://doi.org/10.4097/kjae.1995.29.6.913

Abstract

The causes of pneumomediastinum during perioperative period are trauma to the airway from intubation or other manipulation, raised airway pressure during anesthesia, rupture of a bleb or other intrapulmonary lesion, upper airway damage during neck surgery, infiltration of the tonsillar fossa or adenoid bed with air under pressure, increased airway pressure after nausea and vomiting, and coughing during awakening. This paper is represents and discusses a case of pneumomediastinum, pneumothorax, extensive subcutaneous and retroperitoneal emphysema which occurred suddenly a few minute after several times of bucking and straining in the intubated state with oxygen catheter after tonsillectomy and adenoidectomy at recovery room. The complieation was thought to be a infiltration of air through tonsillar fossa under pressure or alveolar rupture due to increased airway pressure after coughing. The patient was treated with high concentration of oxygen and recoverd uneventfully.

Keyword

Pneumomediastinum; Subcutaneous emphysema; Tonsillectomy and adenoidectomy

MeSH Terms

Adenoidectomy
Adenoids
Anesthesia
Blister
Catheters
Cough
Emphysema
Humans
Intubation
Mediastinal Emphysema*
Nausea
Neck
Oxygen
Perioperative Period
Pneumothorax
Recovery Room
Rupture
Subcutaneous Emphysema*
Tonsillectomy*
Vomiting
Oxygen