Abstract
Abdominal crepitus and associated subcutaneous emphysema on imaging following open gynecologic surgery typically signals life-threatening complications including perforated viscus and necrotizing fasciitis, which require prompt intervention. This case is the second to date after open gynecologic surgery where, after extensive workup, significant subcutaneous emphysema of uncertain etiology was diagnosed with a benign and self-resolving course without any long term sequalae.
Highlights
Subcutaneous emphysema occurs when gas becomes trapped under the skin
The patient underwent exploratory laparotomy and total abdominal hysterectomy for a large fibroid uterus. She developed massive subcutaneous emphysema during her postoperative course which was self-limited without identifiable etiology
We present a second case of benign, self-resolving abdominal crepitus and subcutaneous emphysema following open gynecologic surgery
Summary
Subcutaneous emphysema occurs when gas becomes trapped under the skin. Crepitus, the characteristic crackling feel, is the associated physical exam finding. Subcutaneous emphysema, Crepitus, Abdomen, Myomectomy, Laparotomy, Benign Though common following laparoscopic surgery, abdominal or chest wall crepitus after open surgery should raise immediate concern for traumatic injury or infection [1]. Possible traumatic injuries include spontaneous pneumothorax and perforated viscus with subsequent migration of air through the subcutaneous space, both of which have been extensively reported in the literature [2,3,4,5,6,7,8].
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