A CASE REPORT ON SURGICAL EMPHYSEMA- CO2 COMPLICATION DURING LAPAROSCOPIC CHOLECYSTECTOMY

*P. Nithyakala, Dr. K. Jayaprakash, Indhu Malini N., Dharsshini N. and Hamsavarthini S.

ABSTRACT

Background: The laparoscopic method is the most common type of intra-abdominal surgery and known to reduce post operative morbidity, which instead have a complication of surgical emphysema. Surgical emphysema caused by insufflating gas tracking under pressure into the subcutaneous tissue planes clinically presented below skin. During laparoscopic surgery, absorption of CO2 in the peritoneum is high leading to elevation of CO2 in the blood which is compensated by assisting expiration from the lungs which has high aqueous solubility and infusibility. Case Summary: A 56 years old female patient was admitted in the hospital who was diagnosed with cholelithiasis and proposed for laparoscopic cholecystectomy procedure. During the procedure the patient developed subcutaneous emphysema with elevation in ETC02. The patient was then stabilized, and the procedure was carried out successfully. Conclusion: Post operative complications are rare for laparoscopic surgery and this case report represents the pulmonary abnormality due to the etiology of absorption of CO2. If misdiagnosed or untreated this emphysema may result in respiratory distress. With proper anaesthetic management, it can be resolved.

Keywords: Cholelithiasis; Surgical Emphysema; Cholecystectomy; Laparoscopy.