Management of massive subcutaneous emphysema with a surgical tracheostomy

Abstract EN

Introduction: Interventions for massive subcutaneous emphysema is rarely reported in the literature with lack of comparative studies and strong preferences over one treatment option compared to another.

Tracheostomy is a conservative measure as compared to primary closure of tracheobronchial injury for the management of massive subcutaneous emphysema.

Case report: A 62-year gentleman who developed massive subcutaneous emphysema on the 12th post-operative day following two laparoscopic abdominal surgeries and an exploratory laparotomy.

A computer tomographic scan was performed showing a suspicious tenting of the trachea at right posterolateral wall at the level of T2 vertebra with locules of air seen anterolaterally to the trachea.

A subsequent microlaryngobronchoscopy performed showed no defect in the subglottic region, nor tracheobronchial tree.

He was successfully managed with a surgical tracheostomy whereby the emphysema showed dramatic resolution on the second postoperative day.

Conclusion: Surgical tracheostomy demonstrated a success in managing massive subcutaneous emphysema.