Development of pneumomediastinum and subcutaneous emphysema after laparoscopic cholecystectomy

Abstract

Pneumomediastinum is defined as the presence of air in mediastinum. This clinical entity is mostly seen due to sudden increase in pressure within the alveoli and rupture of the alveoli. Laparoscopic cholecystectomy was performed in a 26 years old women who suffered from gallstone cholecystitis. In the early postoperative period swelling at the neck and face were observed and subcutaneus emphysema and pneumomediastinum were diagnosed. In broncoscopy, superficial laceration of the tracheal mucosa was observed at the posterior wall. The patient was clinically well and taken under close observation and medical treatment with antibiotics (cephazolin 500 mg 2x1, iv), nasal oxygen and antitussive (pentoxyverin 1.5 mg/ml 3x1, p.o), restriction of activity, avoiding any increase in the intraabdominal pressure and coughing. No complication was observed during the follow-up period and the patient was discharged from the hospital postoperative on the fifth day. Controls of the patient were normal on 1 week and 1 month after discharge. This case is presented due to its rarity and literature is reviewed.