Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942007000400010
Brazilian Journal of Anesthesiology
Clinical Information

Enfisema subcutâneo durante inclusão de prótese mamária: relato de caso

Subcutaneous emphysema during breast augmentation: case report

Talita Franco; Diogo Franco; Natan Treiger

http://dx.doi.org/10.1590/S0034-70942007000400010 Braz J Anesthesiol, vol.57, n4, p.414-420, 2007
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Resumo

JUSTIFICATIVA E OBJETIVOS: A ocorrência de enfisema subcutâneo na parede torácica durante procedimento cirúrgico onde se realizou infiltração de anestésico pode sugerir a presença de pneumotórax e suas possíveis complicações. A ocorrência de pneumotórax durante mamoplastia de aumento já foi descrita. Contudo, não foram encontrados na literatura pesquisada, relatos de presença isolada de enfisema subcutâneo nesse tipo de procedimento. O objetivo deste relato foi ressaltar a importância de adequada monitoração do paciente no intra-operatório, da integração dos membros da equipe e descrever o enfisema subcutâneo, isolado, em paciente submetida à inclusão de próteses mamárias. RELATO DO CASO: Paciente com 27 anos, 1,70 m, 54 kg, apresentava hipomastia bilateral, tendo sido submetida à inclusão de próteses mamárias em plano retroglandular. O procedimento foi realizado sob anestesia geral inalatória, associada à infiltração de solução anestésica, em plano subcutâneo, da área a ser manipulada. Durante a operação percebeu-se crepitação, característica de enfisema subcutâneo, em extensa área anterior do tórax. Não houve alteração nos parâmetros de monitoração da paciente. A radiografia realizada no pós-operatório confirmou o quadro clínico e descartou a ocorrência de outras complicações. CONCLUSÕES: A ocorrência de enfisema subcutâneo durante inclusão de próteses mamárias pode ser um dado inocente, mas é importante verificar as condições clínicas da paciente e afastar a possibilidade de pneumotórax.

Palavras-chave

CIRURGIA, Plástica, COMPLICAÇÕES

Abstract

BACKGROUND AND OBJECTIVES: Subcutaneous emphysema of the thoracic wall during a surgical procedure with infiltration of local anesthetics may suggest the presence of pneumothorax and its complications. The development of pneumothorax during breast augmentation has already been reported; however, we did not find any reports in the literature on isolated subcutaneous emphysema during this type of procedure. The objective of this report was to emphasize the importance of adequate intraoperative monitoring of the patient, integration of team members, and describe the isolated subcutaneous emphysema in a patient during breast augmentation. CASE REPORT: A 27 years old patient with 1.70 m and 54 kg, with bilateral hypomasty, underwent breast augmentation in a retroglandular plane. It was done under inhalational general anesthesia associated with infiltration of an anesthetic solution in the subcutaneous tissue in the area to be manipulated. During the procedure, crepitation, characteristic of subcutaneous emphysema, was observed over a large area of the anterior thorax. There were no changes in monitoring parameters. Postoperative chest X-rays confirmed the clinical diagnosis and ruled out the presence of other complications. CONCLUSIONS: Subcutaneous emphysema during breast augmentation can be an innocent sign, but it is important to evaluate the patient to rule out the presence of a pneumothorax.

Keywords

COMPLICATIONS, SURGERY, Plastic

References

Benumof JL, Saidman LJ. Anesthesia & Perioperative Complications. 1999:59-60.

Shapiro BA, Peruzzi WT. Complications of Positive Airway Pressure Therapy. Anesthesia. 1994:2425-2427.

Denlinger JK. Complications in Anesthesiology. 1996:241-249.

Pfulg ME, Favre S, Verdeja R. Bilateral pneumothoraces: a rarely described complication following augmentation mammaplasty. Aesth Surg J. 2005;25:49-52.

Kaye AD, Eaton WM, Jahr JS. Local anesthesia infiltration as a cause of intraoperative tension pneumothorax in a young healthy woman undergoing breast augmentation with general anesthesia. J Clin Anesth. 1995;7:422-424.

Marcano G, Rabanal JM, Monslera R. Enfisema subcutáneo sin neumotórax trás intubación difícil. Rev Esp Anestesiol Reanim. 1993;40:319-320.

Benito MC, Gago MS, Gutierrez A. Enfisema subcutâneo y neumomediastino como complicación tardia de una intubación difícil. Rev Esp Anestesiol Reanim. 1995;42:436-437.

Fuentes A, Sala X, Pessas JP. Enfisema subcutâneo y mediastinico trás intubación orotraqueal no dificultosa. Rev Esp Anestesiol Reanim. 1996;43.

Castiglia YMM, Machado PRDM, Amorim RB. Enfisema subcutâneo pós-operatório: Relato de casos. Rev Bras Anestesiol. 1993;43:205-207.

Moore DC. Regional Block. 1978.

Osborn JM, Stevenson TR. Pneumothorax as a complication of breast surgery: Free presentation, Aesthetic Meeting, American Society for Aesthetic Plastic Surgery. May,.

Pay AD, Crick A. Subcutaneous emphysema of a digit through a pre-existing puncture wound. Brit J Plast Surg. 1999;52:505-506.

Nishino H, Kenmochi M, Kasugai S. Subcutaneous emphysema secondary to tonsillectomy: a case report. Auris Nasus Larynx. 2003;30:S135-S136.

Saglam M, Tasar M, Güleç B. Pneumoscrotum following perineal trauma. Eur J Radiol Extra. 2003;45:26-29.

Monaghan AM, Millar BG. Orbital emphysema during air travel: a case report. J Craniomaxillofac Surg. 2002;30:367-368.

Reeves DL, Lucarelli MJ, Rose JG. Severe subcutaneous emphysema following orbital blowout fracture. Ophthal Plast Reconstr Surg. 2005;21:465-467.

Aggarwal NK, Meyer DR. Massive periorbital emphysema associated with laparoscopic nephrectomy. Ophthal Plast Reconstr Surg. 2004;20:394-395.

Jean A, Sanelli PC, Honrado C. Cervical subcutaneous emphysema after lower abdominal laparoscopic surgery. Otolaryngol Head Neck Surg. 2003;128:157-159.

Worrell JB, Cleary DT. Massive subcutaneous emphysema and hypercarbia: complication of carbon dioxide absorption during extraperitoneal and intraperitoneal laparoscopic surgery: case studies. AANA J. 2002;70:456-461.

Murdock CM, Wolff AJ, Van Geem T. Risk factors for hypercarbia, subcutaneous emphysema, pneumotorax, and pneumomediastinum during laparoscopy. Obstet Gynecol. 2000;95:704-709.

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