Unilateral periorbital emphysema: an unusual complication of endoscopic papillotomy

Unusual occurrence of massive subcutaneous emphysema during ERCP under general anaesthesia

“…[23456] This is expected when one looks at the mechanisms of progress of extraluminal air (vide infra). In addition, non-surgical management is the preferred approach to such complications since all instances of extraluminal air are not associated with retroduodenal perforations.…”

“…[67] In our case, immediate surgery was contemplated as an extensive emphysema appeared in a short time. Additionally, the patient was under general anaesthesia which allowed quick surgical intervention.…”

Subcutaneous Emphysema, Pneumothorax and Pneumomediastinum Following Endoscopic Sphincterotomy

“…Complete resolution with conservative management was reported in four other cases of subcutaneous emphysema following ERCP [6-8, 11]. There are two reports of retroperitoneal perforation treated surgically [9, 10], and in one of these cases the perforation site was not identified during surgery [10].…”

“…However, most cases turn out well with minor clinical manifestations if an early diagnosis is made [5]. Subcutaneous emphysema, pneumomediastinum and pneumothorax as a result of retroperitoneal perforation after sphincterotomy are rarely reported complications [6-11]. We report the case of a patient with post-ERCP subcutaneous emphysema, pneumomediastinum and pneumothorax treated conservatively.…”

Colonic perforation during laparoscopic hernia repair presented as delayed generalized subcutaneous emphysema: a clue to intra-abdominal complication

“…The investing layer covering trachea and esophagus extend from the neck inferiorly through the hiatus in to the retroperitoneal space. 7 There is no reports regarding the exact rate of incidence of subcutaneous emphysema accompanied by pneumothorax and pneumomediastinum, but, the incidence of subcutaneous emphysema alone was reported between 0.43% and 2.34%. 8 It is believed that most of subcutaneous emphysema, pneumothorax and pneumomediastinum, goes undiscovered, making the real incidence higher than the reported one.…”