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Surgical emphysema following shoulder arthroscopy – A case report and review of a less recognized complication

Arthroscopy is an established modality of treatment for various conditions of the shoulder attributable to its minimally invasive nature. The possibility of surgical procedure-related complications is usually low. However, there have been sporadic reports of surgical emphysema following shoulder arthroscopy that can range from simple subcutaneous emphysema to life-threatening pneumothorax (PT) and pneumomediastinum (PM). The mechanism of this phenomenon is still elusive. We report the case of a 41-year-old female without pre-existing lung problems who developed extensive subcutaneous emphysema, PT, and PM after shoulder arthroscopy in the absence of an identifiable tracheal injury and masquerading as angioedema. We have extensively reviewed available literature and the mechanisms proposed have been analyzed. Acknowledging the existence of such a complication along with high degree of suspicion will help tackle the problem early and avert unforeseen complications.