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Nitrogenous subcutaneous emphysema caused by spray application of fibrin glue during retroperitoneal laparoscopic surgery

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Abstract

We report a case of a patient treated by retroperitoneoscopic partial nephrectomy who developed nitrogenous subcutaneous emphysema (SCE) as a complication. The use of a nitrogen gas-pressured fibrin tissue adhesive applied as a spray caused excessively increased pressure in the closed retroperitoneal space and resulted in widespread SCE with protracted clinical course. To the best of our knowledge, this is the first report of nitrogenous SCE associated with pneumoperitoneum. The clinical significance of nitrogenous SCE is emphasized, and the risks associated with the use of fibrin glue as a spray during laparoscopic surgery are discussed.

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Authors and Affiliations

  1. Department of Anesthesia, Kasukabe-chuo General Hospital, Midori-cho 5-9-4, Kasukabe, Saitama, 344-0063, Japan

    Shinji Matsuse, Atsushi Maruyama & Yoshiki Hara

  2. Department of Emergency and Critical Care Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan

    Shinji Matsuse

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  1. Shinji Matsuse
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  2. Atsushi Maruyama
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  3. Yoshiki Hara
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Correspondence to Shinji Matsuse.

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Matsuse, S., Maruyama, A. & Hara, Y. Nitrogenous subcutaneous emphysema caused by spray application of fibrin glue during retroperitoneal laparoscopic surgery. J Anesth 25, 426–430 (2011). https://doi.org/10.1007/s00540-011-1120-9

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  • DOI: https://doi.org/10.1007/s00540-011-1120-9

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