Abstract
We describe a case in which severe pneumomediastinum and bilateral pneumothorax developed after tracheotomy. A 68-year-old man underwent tracheotomy with local anesthesia and then laryngomicrosurgery for laryngeal tumor was performed under sevof lurane - nitrous oxide-oxygen anesthesia. After the surgery, the laryngoflex tube was replaced with a tracheotomy tube, when he developed severe bucking. A chest x-ray revealed severe pneumomediastinum and bilateral pneumothorax. It was speculated that an extreme negative intrathoracic pressure induced by a bucking drew air into the mediastinum through the torn cervical fascias. This may have caused pneumomediastinum and rupture of the mediastinal pleura, resulting in severe bilateral pneumothorax.
