A 6-year-old boy with a history of obstructive sleep apnea and recurrent tonsillitis was admitted for adenotonsillectomy. His tonsils showed grade five enlargement that almost met at the midline. Lateral nasopharyngeal X-ray showed that his adenoids blocked 90% of the airway. All other examinations, including electrocardiography and chest radiography, were normal. Adenotonsillectomy with endotracheal intubation was performed under general anesthesia, and the adenoids were removed.
The surgical procedure was uneventful without any early postoperative complications. The patient recovered from anesthesia within 15 mins. However, during the first postoperative hours, the patient had an episode of emesis. He also developed dyspnea and generalized swelling of the face, neck, and chest with marked crepitus on palpation after three hours of operation. Physical examination Patient was conscious.…
