Abstract
Subcutaneous emphysema (SE) is a rare complication of laparoscopic procedures, with an incidence rate of only 0.43–2.3%. In this report, we present a case of a 28-year-old male who underwent an elective laparoscopic inguinal hernia repair and developed surgical emphysema, hypercarbia and respiratory acidosis intraoperatively. Based on our findings, we concluded that regardless of the low incidence of SE, awareness of the associated risk factors should be ensured to avoid laparoscopic procedure-related complications.
INTRODUCTION
Subcutaneous emphysema (SE) is defined as a “finding of gas within subcutaneous soft tissues, usually in the thorax or neck” [1]. The severity of SE has been classified according to a recent study based on the anatomical extension of SE into five grades: first including the base of the neck; second, all the neck area; third, the subpectoralis major area; fourth, the chest wall and all of the neck area and fifth, the chest wall, neck, orbit, scalp, abdominal wall, upper limbs and scrotum [2].
DISCUSSION
Laparoscopic procedures are overall considered safe, with a low rate of serious complications, of which up to 50% occur while gaining abdominal access or at the time of port placement [5]. While the rest of the complications occur during abdominal insuff lation, tissue dissection and hemostasis [6]. The primary insuff lation gas used in laparoscopic procedures to create a pneumoperitoneum is CO2, which has been favored over other gases due to its high solubility [7].
