Subcutaneous Emphysema following Laparoscopic Cholecystectomy / 대한마취과학회지

ABSTRACT

Subcutaneous emphysema is one of the complications of the pneumoperitoneum necessary to perform laparoscopy. We experienced a case of extensive subcutaneous emphysema which was manifested by severe hypercarbia with respiratory acidosis and tachycardia during laparoscopic cholecystectomy in 65 years old female patient. Hypercarbia was reversed rapidly by hyperventilation and subcutaneous emphysema was resolved spontaneously on postoperative 3rd day almostly. The possible cause of subcutaneous emphysema in this case is dissection of the insufflated carbon dioxide from the peritoneal cavity via a trocar site to a tract along subcutaneous tissue planes. Immediate recognition, evaluation, and treatment is necessary since this can be a life threatening complication. And tension peu-mothorax should be ruled out. It is safe to monitor end tidal carbon dioxide tension or arterial carbon dioxide tension during the laparoscopic cholecystectomy.