Korean J Anesthesiol.  1996 Dec;31(6):811-816. 10.4097/kjae.1996.31.6.811.

Pneumomediastinum, Subcutaneous Emphysema, Pneumoperitoneum and Pneumoretroperitoneum after Nephrectomy: A case report

• So EH
• Kim IJ
• Kim TW
• Kyoun IS

• KMID: 2236918
• DOI: http://doi.org/10.4097/kjae.1996.31.6.811

Abstract

Pneumomediastinum, air within the planes of the mediastinum, occurs in a wide variety of clinical settings. In the perioperative period, pneumomediastinum is caused by various anesthetic and surgical complications, but may appear spontaneously. When pneumomediastinum occurs with no apparent cause, it is referred to as a spontaneous pneumomediastinum. The suggested mechanism of spontaneous pneumomediastinum is rupture of marginal alveoli due to increased intraalveolar pressure and dissection of air along the bronchovascular sheath into the mediastinum. Predisposing factors include raised intrathoracic pressure, as with coughing, vomiting, and Valsalva maneuvers. The auther's case is presented of pneumomediastinum, with subcutaneous emphysema, pneumoperitoneum, and pneumoretroperitoneum, occurring one day postoperatively, in a 26-year-old female patient who underwent nephrectomy under general anesthesia. The patient was treated conservatively with oxygen and had an uneventful recovery. The authors discuss the possible causes and its management with a review of the relevant literature.

Keyword

Complication; postoperative pneumomediastinum; subcutaneous emphysema; pneumoperitoneum; pneumoretroperitoneum; Surgery; urologic nephrectomy

MeSH Terms

Adult
Anesthesia, General
Causality
Cough
Female
Humans
Mediastinal Emphysema*
Mediastinum
Nephrectomy*
Oxygen
Perioperative Period
Pneumoperitoneum*
Retropneumoperitoneum*
Rupture
Subcutaneous Emphysema*
Valsalva Maneuver
Vomiting
Oxygen