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January 1955


Author Affiliations

Galveston, Texas
From the Department of Surgery, University of Texas Medical Branch.

AMA Arch Surg. 1955;70(1):140-142. doi:10.1001/archsurg.1955.01270070142025

POSTOPERATIVE subcutaneous emphysema has been reported by numerous authors. Usually it is associated with a defect in the respiratory system, and it is often a complication of general anesthesia.1 One of two mechanisms usually is involved. When concomitant wounds occur in the parietal pleura, visceral pleura, and lung, air will pass from the injured lung across the pleural space with or without pneumothorax being apparent on roentgenograms during the early stages. The other mechanism which may be involved is the rupture of overdistended alveoli as a result of overinflation of the lungs, resuscitative measures, atelectasis with compensatory emphysema, or straining. Air bubbles escaping from the alveoli into the perivascular sheaths of capillaries and larger blood vessels coalesce and are pushed throughout the lung substance and down the lung root into the mediastinum. There are three main routes of egress from the mediastinum: the subcutaneous tissues of the neck, the

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