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A 77-year-old woman underwent laminectomy and posterior spinal fusion from T12 to S1, an operation that was performed while she was in the prone position. At the conclusion of the operation, she was placed in the supine position and taken to the intensive care unit, where her airway pressure rapidly became elevated and massive subcutaneous emphysema and hypoxemia developed. A chest radiograph revealed subcutaneous emphysema but no obvious pneumothorax (Panel A). Bilateral chest tubes were placed, but the patient's hypoxemia did not improve. A computed tomographic scan showed a dramatic amount of subcutaneous emphysema (Panel B, arrowheads) and identified a . . . [Full Text of this Article] |
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