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Pneumomediastinum, pneumothorax and subcutaneous emphysema following cryoinsufflation for the treatment of hidradenitis suppurativa

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Abstract

The treatment of hidradenitis suppurativa is challenging. Recently, cryoinsufflation was described for treating this perplexing condition. We hereby report the occurrence of pneumomediastinum, pneumothorax, and extensive subcutaneous emphysema following the treatment of sternal hidradenitis suppurativa by cryoinsufflation. These complications were gradually resolved spontaneously under careful observation. Notwithstanding that the trapped gas in the subcutaneous and lung tissues in our patient gradually reabsorbed spontaneously, we are now in the opinion that cryoinsufflation in the thorax area should be performed under deep sedation or general anesthesia, with close observation of the patient including overnight hospitalization and monitoring by oximetry. Alternatively, the use of different cryosurgery techniques such as contact or intralesional methods could be considered.

Level of evidence: Level V, risk study

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Acknowledgment

The authors extend their appreciation to Professor Emeritus B. Hirshowitz FRCS for his help in editing this manuscript for publication.

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Correspondence to Y. Har-Shai.

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For this type of study formal consent from a local ethics committee is not required.

Conflict of interests

A. Kramer, I. Metanes, N. Eyal, L. Brizgalin, S. Halabi, L. Har-Shai, Y. Har-Shai declare that they have no conflict of interest.

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Patient provided written consent before her inclusion in this study. Additional consent was obtained for the use of her images.

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I. Metanes equally contributed as the first author.

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Kramer, A., Metanes, I., Eyal, N. et al. Pneumomediastinum, pneumothorax and subcutaneous emphysema following cryoinsufflation for the treatment of hidradenitis suppurativa. Eur J Plast Surg 40, 71–74 (2017). https://doi.org/10.1007/s00238-016-1230-6

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  • DOI: https://doi.org/10.1007/s00238-016-1230-6

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