經尿道攝護腺雙極剜除手術後的皮下氣腫：病例報告及文獻回顧
戴大堯、楊文宏
國立成功大學附設醫院 泌尿部
Subcutaneous emphysema after transurethral enucleation with bipolar: a case report with literature review
Ta-Yao Tai, Wen-Horng Yang
Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
Transurethral resection of the prostate (TURP) is the standard surgical treatment for benign prostate hyperplasia. In recent years, transurethral enucleation with bipolar (TUEB) had been established with similar outcomes and comparable complication rate with other transurethral procedures. This present report describes a 74 year-old man suffering from severe low urinary tract symptoms and repeat urine retention received TUEB. However, swelling of abdomen and bilateral flank was noted after operation. He also complained abdominal discomfort, bilateral shoulder soreness, exertional dyspnea and dizziness. Abdomen X-ray showed severe subcutaneous emphysema and chest plain film revealed left costovetebral angle blunting suspected left pleural effusion. Fluid overload was impressed and diuretics was administered. Dyspnea and subcutaneous emphysema improved after few days conservative management.
Due to the rarity of subcutaneous emphysema of transurethral enucleation with bipolar instrument, herein we also reviewed the literature of the all complication, diagnosis, prevention and management.