Pneumomediastinum and retroperitoneal air after removal of papillomas with the microdebrider and jet ventilation
Sims, H.S.; Lertsburapa, K.
Journal of the National Medical Association 99(9): 1068-1070
2007
ISSN/ISBN: 0027-9684 PMID: 17913120 Document Number: 613154
To discuss the complication of pneumothorax from alveolar rupture after transtracheal high-frequency jet ventilation and to present a case of pneumothorax, pneumomediastinum and pneumoperitoneum after jet ventilation coupled with use of the microdebrider. Detailed case report. Unilateral pnuemothorax, subcutaneous emphysema, pneumomediastinum and retroperitoneal air discovered after jet ventilation for removal of airway papillomas resolved with conservative management. We discuss the difference between the respective patterns of air seepage in a peripheral alveolar injury versus a probable microperforation in the trachea. We also review the epidemiology of this rare disorder and its incidence in the African-American community. The recurrent nature of this disorder mandates multiple surgical procedures. Great care must be taken to eradicate disease and avoid complications. Pneumomediastinum in this setting can be managed conservatively.