Surgical emphysema, bilateral pneumothorax, pneumomediastinum and pneumoperitoneum complicating intubation for anaesthesia

Abstract

Summary A combination of surgical emphysema, bilateral pneumothorax, pneumomediastinum and pneumoperitoneum complicating anaesthesia using endotracheal intubation has been reported only once before. Its occurrence twice in a recent period of 4 months at one hospital suggests that it may not be rare. Recognition of the early signs should enable steps to be taken before irreversible cerebral damage has occurred.

Pneumopericardium and pneumomediastinum complicating endotracheal intubation

“…Occasional reports of trauma to the trachea from endotracheal intubation in adults have appeared in the literature (Thompson and Read, 1968) but most have been of children and particularly of newborn infants (Fearon et al, 1966). A combination of surgical emphysema, pneumothorax, pneumomediastinum and pneumoperitoneum has been described (Scott and Viner, 1975) and pneumopericardium has been documented following endotracheal intubation in the neonatal period (Moodie et al, 1976). Mansfield et al (1973) felt that pneumopericardium occurred almost exclusively in pre-term newborn infants with idiopathic respiratory distress syndrome (IRDS).…”