Massive Subcutaneous Emphysema and Uncontrolled Hypercarbia during Laparoscopic Assisted Distal Gastrectomy: A case report.
10.4097/kjae.2007.53.3.382
- Author:
Jong Cook PARK
1
;
Yun Suk CHOI
;
Sang Hyun PARK
Author Information
1. Department of Anesthesiology and Pain Medicine, Cheju National University College of Medicine, Jeju, Korea. lanlan@cnuh.org
- Publication Type:Case Report
- Keywords:
hypercarbia;
hyperventilation;
laparoscopy;
subcutaneous emphysema
- MeSH:
Carbon Dioxide;
Gastrectomy*;
Humans;
Hyperventilation;
Insufflation;
Laparoscopy;
Neck;
Pneumoperitoneum;
Recovery Room;
Subcutaneous Emphysema*;
Thorax
- From:Korean Journal of Anesthesiology
2007;53(3):382-386
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
We experienced a case of massive subcutaneous emphysema and marked hypercarbia during a laparoscopic assisted distal gastrectomy. Forty minutes after the start of pneumoperitoneum, the end-tidal carbon dioxide (CO2) tension was raised rapidly up to 70 mmHg. At this time, subcutaneous emphysema was detected on the neck and anterior chest of the patient. Carbon dioxide insufflation was then stopped, and surgery was restarted when the end-tidal CO2 level was normalized. During a second laparoscopic trial, the patient developed hypercarbia unresponsive to marked hyperventilation. As the laparoscopic procedure terminated, the end-tidal CO2 level no longer increased. Subcutaneous emphysema remained even at the recovery room. The patient was transferred to a ward in the usual procedure, and was discharged uneventfully nine days thereafter.
