Post Operative Severe Subcutaneous Emphysema

Introduction: Nowadays establishment of a safe and secure airway for general anesthesia is necessary and establishment of the airway , according to the anatomical and physiological state, may be accompanied with complications such as piriform sinus damage resulting to subcutaneous emphysema. Subcutaneous emphysema and pneumomediastinum are rare complications of tracheal intubation and if not be treated they may be life threatening. Case Report: A 48-year-old female patient with main complain of tearing due to bilateral lacrimal duct obstruction was scheduled for endoscopic dacryocystorhinostomy surgery. Preopreative routine physical examination, laboratory tests and laryngoscopic view were normal. The patient had not any problem during tracheal intubation and surgery, but 90 minutes after recovery from anesthesia, severe subcutaneous emphysema in the neck occurred followed by coughing.Therefore the patient was shifted to the intensive care unit for complete care and discharged after 13 days. Conclusion: Candidates for general anesthesia patients without any problem in tracheal intubation regarding to their laryngoscopic view and routine examinations , undergoing invasive techniques such as all intubation stages , nasogastric tube insertion and deep oral suction especially with thick catheter have a high rates of air way injuries and subcutaneous emphysema