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Nontraumatic subcutaneous emphysema in association with rectal carcinoma.

Nontraumatic subcutaneous emphysema is a rare complication of colorectal cancer. To the authors' knowledge, only eight cases have been reported to date. The initiating event was free colonic perforation in seven of the patients and contained colosubcutaneous fistula in the eighth. In nontraumatic subcutaneous emphysema typical fecal flora is cultured, whereas in nontraumatic gas gangrene, a different clinical entity that has a fulminant course, the bacteria are generally clostridial. The authors report a case of nontraumatic subcutaneous emphysema associated with rectal carcinoma and describe the associated computed tomography findings.

Adenocarcinoma↗

[Subcutaneous emphysema and pneumomediastinum after dental drilling].

Subcutaneous emphysema and pneumomediastinum is a rare complication of dental treatment. Our case report describes a case secondary to dental drilling with a high-speed air drill, and diffusion of the compressed air. Our case had the classical clinical features of sudden subcutaneous emphysema starting in the face, and subsequently extending into the neck and thorax, accompanied by severe pain and dyspnoea. Rapid medical treatment for this emergency avoided the surgical decompression.

Adult↗

Cervicofacial subcutaneous emphysema after lower root canal therapy.

Subcutaneous emphysema can occur when high-speed, air-cooled, rotary cutting instruments are used near open wounds and introduce air into subcutaneous or facial spaces of the face and neck. The case reported here describes an episode of cervicofacial subcutaneous emphysema after lower tooth root canal therapy.

Adult↗

Subcutaneous emphysema as a complication of tonsillectomy.

Subcutaneous emphysema occurs when air is introduced into the tissues. This can happen as a complication during, or immediately after surgery. It has rarely been described after tonsillectomy. Definitive treatment will depend on the cause. We report two cases of subcutaneous emphysema following tonsillectomy.

Adolescent↗

Subcutaneous emphysema after tonsillectomy: a case report.

We experienced a case of a subcutaneous emphysema after tonsillectomy. The patient, a 24-year-old man, complained of a recurrent sore throat and was diagnosed as having chronic tonsillitis. Pre-operative general examinations revealed no abnormalities. The operation was carried out under general anesthesia. The adhesions between the tonsils and the surrounding tissues were moderate. The bi-lateral tonsils were easily removed. The recovery period was uneventful. On the next morning, marked swelling of the left cheek and submandibular area was noted. On palpation, there was a characteristic crepitation and softness in these areas. The X-ray examination revealed subcutaneous emphysema. There was no finding of airway obstruction. We diagnosed him as having a subcutaneous emphysema and administered antibiotics for 5 days. From clinical findings, the subcutaneous emphysema was thought to be caused by surgical rather than anesthetic factors. The subcutaneous emphysema gradually disappeared. One year after the tonsillectomy, the patient is under observation as an outpatient and is free from any abnormal symptoms. To avoid this kind of complication, we should pay attention to carefully separate the tonsil from its fossa and to make appropriate selection of surgical equipments.

Adult↗

[A rare cause of subcutaneous emphysema].

A rare cause of subcutaneous emphysema is described which developed in two patients after epidural anaesthesia. Only two case reports could be found in literature describing similar conditions. The anaesthesia is performed using the "loss of resistance" technique with injection of air for the identification of the epidural space. Possible explanations for the development of the emphysema are discussed.

Aged↗

Benign noninfectious subcutaneous emphysema of the hand.

A 17-year-old girl presented pain and subcutaneous crepitation in the left hand. Because of lack of systemic symptoms, non-infectious cause was considered. Radiographic and magnetic resonance imaging revealed subcutaneous emphysema. A chest x-ray was reported as normal but chest computerised tomography revealed pneumomediastinum. On the third day of the hospitalisation, subcutaneous emphysema spread to arm, shoulder, head, left hemithorax, back, bilateral supraclavicular, cervical, submandibular and periorbital regions. Pneumomediastinum and subcutaneous emphysema disappeared during 6 weeks of follow up with conservative methods. This might have prevented unnecessary surgical intervention. This report demonstrates that benign non-infectious subcutaneous emphysema of the hand due to pneumomediastinum should be kept in mind in hand surgery.

Adolescent↗