Massive Subcutaneous Emphysema and Bilateral Pneumothorax after TISSEEL Spray in Laparoscopic Surgery

Abstract

1. Case Report A 33 years old female without systemic disease received laparoscopic ovarian cystectomy and chromotubation. The operation time was 60 minutes. During the surgery, the intraabdominal pressure was limited between 12 and 15 mm Hg. The ETCO2 was about 35 mmHg and the airway pressure was about 22 cm H2O. At the end of operation, TISSEEL [Fibrin Sealant] was delivered by TISSEEL spray set with piped air. The intraabdominal pressure suddenly rose above 20 mmHg, and the peek airway pressure exceeded 40 mmHg. Massive emphysema extending to the face and neck were noted, and bilateral pneumothorax were also found (Figure 1) There were some petechia over her chest. She was transferred to SICU and the condition was relatively stable. She was discharged uneventually after one week.