Castillo-Aznar J, Delgado-Domingo JA, Tejedor-Vargas P, Peña-De Buen N, Mateo-Orobia AJ, Lafuente-Ojeda N

Language: Spanish
References: 9
Page: 133-136
PDF size: 356.27 Kb.

ABSTRACT

Subcutaneous emphysema can be defined as the aerial infiltration of the subcutaneous cellular tissue of the face, neck, trunk, abdomen and less frequent extremities. The main etiology is rupture of the respiratory tree. We present the case of a male who was operated for atypical resection of the right lower lobe due to lung neoplasia. The surgical procedure was uneventful. During the admission to the postoperative intensive care unit, there is a slight air leak in the thoracic drainage. Two hours later the patient started with tachypnea, increased respiratory work and subcutaneous thoracic emphysema that extended to the cervicofacial and palpebral zone, progressing towards the arms, abdominal wall and scrotum. Thoracic surgeon indicated replacement of the thoracic drainage and perform cutaneous incisions for the drainage of emphysema. The patient needed respiratory support and vasoactive drugs. After a correct pulmonary reexpansion, reduction of aerial leakage and progressive resolution of subcutaneous emphysema, the patient was extubated. The first choice in the management of subcutaneous emphysema is the expectant attitude. In the most serious cases, the priority is to control the airway and eliminate the triggering cause, and it is possible to propose invasive treatments that accelerate the resolution of the condition.

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