Pneumomediastinum, pneumothorax and subcutaneous emphysema following cryoinsufflation for the treatment of hidradenitis suppurativa

Abstract

The treatment of hidradenitis suppurativa is challenging. Recently, cryoinsufflation was described for treating this perplexing condition. We hereby report the occurrence of pneumomediastinum, pneumothorax, and extensive subcutaneous emphysema following the treatment of sternal hidradenitis suppurativa by cryoinsufflation. These complications were gradually resolved spontaneously under careful observation. Notwithstanding that the trapped gas in the subcutaneous and lung tissues in our patient gradually reabsorbed spontaneously, we are now in the opinion that cryoinsufflation in the thorax area should be performed under deep sedation or general anesthesia, with close observation of the patient including overnight hospitalization and monitoring by oximetry. Alternatively, the use of different cryosurgery techniques such as contact or intralesional methods could be considered.

Level of evidence: Level V, risk study

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