Subcutaneous emphysema and pneumomediastinum after endotracheal anaesthesia.

INTRODUCTION We report a case of subcutaneous emphysema and pneumomediastinum that presented postoperatively after tracheal extubation. CLINICAL PICTURE A 51-year-old man had an uneventful anaesthesia lasting about 6.5 hours. Intubation was performed by a very junior medical officer and was considered difficult. He developed sore throat, chest pain, numbness of both hands and palpable crepitus around the neck postoperatively. Chest X-ray revealed diffuse subcutaneous emphysema, pneumomediastinum and possible pneumopericardium. TREATMENT He was treated conservatively with bed rest, oxygen, analgesia, antibiotic prophylaxis, reassurance and close monitoring. OUTCOME The patient made an uneventful recovery. CONCLUSIONS We discussed the possible causes.