Bilateral pneumothoraces, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema after percutaneous tracheostomy -A case report-

Abstract

We report a rare case of a 72-year-old female who developed extensive subcutaneous emphysema, bilateral pneumo- thoraces, pneumomediastinum, pneumoperitoneum, and pneumoretroperitoneum after a percutaneous dilatational tracheostomy. The patient's T-cannula was accidentally connected to the oxygen line with a non-perforated connector. The patient rapidly developed respiratory insufficiency and subcutaneous emphysema in the neck and both shoulders. The bilateral pneumothoraces were managed using a chest tube. CT scans of the chest, abdomen, and pelvis revealed an extensive distribution of air throughout the chest and abdomen. The patient was treated successfully with supportive care. This case illustrates the rare occurrence of air passing into multiple body compartments, highlighting the potentially serious complications of a tracheostomy and the importance of intensive care during the recovery period. © the Korean Society of Anesthesiologists, 2012.