Abstract
Massive subcutaneous emphysema is a rare complication in laparoscopic surgery. Complications such as insufflation, pneumothorax, pneumomediastinum to the preperitoneal area during pneumoperitoneum have also been reported in laparoscopic surgery. A 32-year-old, Body Mass Index (BMI) 26.2 kg/m2, woman was admitted for laparoscopic cystectomy because of right ovarian cyst. The end-tidal carbon dioxide values of the patient started to increase (end-tidalCO2:49mmHg) 20 minutes after starting CO2 insufflation (P:15mmHg). Subcutaneous emphysema was detected in face and neck, eyelids and PaCO2 was measured 59mmHg. Patient was extubated after positive pressure ventilation. Emphysemia in the face area including the eyelid continued in the 12th hour of the patient's emphysema completely regressed. Prolonged surgery, CO2 gas insufflation pressure ≥15mmHg, 6 or more trocar access, older age may reduce subcutaneous resistance and causes emphysema. In this case, we would like to highlight to massive subcutaneous emphysema in laparoscopic surgeries.
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