{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T21:32:34Z","timestamp":1771018354314,"version":"3.50.1"},"reference-count":3,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,1,5]]},"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>A 30-year-old woman presented to the accident and emergency department 3 days post-tonsillectomy with bleeding from the tonsillar fossa and left-sided facial swelling. The patient denied any dysphagia or breathing difficulties but experienced pain on neck movement. On examination, although the bleeding had stopped on reaching the emergency department, a small clot was noted in her left tonsillar fossa. A left facial\/submandibular swelling was seen, which had been present since her operation and was slowly enlarging. Flexible nasendoscopy showed a mild left sided oropharyngeal swelling but was otherwise normal. She was treated initially with antibiotics and hydrogen peroxide gargles. After 24\u2009hours of observation and a slight worsening of the swelling she underwent a CT of the neck. This showed widespread indurated subcutaneous surgical emphysema, originating from the left tonsillar bed. Following a period of observation and improvement in her symptoms, she was discharged home with safety netting.<\/jats:p>","DOI":"10.1136\/bcr-2018-228377","type":"journal-article","created":{"date-parts":[[2019,1,21]],"date-time":"2019-01-21T05:39:28Z","timestamp":1548049168000},"page":"e228377","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Potential life-threatening complication of tonsillectomy: cervicofacial surgical emphysema"],"prefix":"10.1136","volume":"12","author":[{"given":"Kirsten","family":"Shoemaker","sequence":"first","affiliation":[{"name":"Otolaryngology Department, NHS Lothian, Livingston, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4121-8762","authenticated-orcid":false,"given":"Christopher SG","family":"Thompson","sequence":"additional","affiliation":[{"name":"Otolaryngology Department, NHS Lothian, Livingston, UK"},{"name":"Anatomy, Division of Health Sciences, University of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupali","family":"Sawant","sequence":"additional","affiliation":[{"name":"Otolaryngology Department, NHS Lothian, Livingston, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gundula","family":"Thiel","sequence":"additional","affiliation":[{"name":"Otolaryngology Department, NHS Lothian, Livingston, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,1,20]]},"reference":[{"key":"2025082803275975000_12.1.e228377.1","first-page":"121","article-title":"Facial subcutaneous emphysema as a rare complication of tonsillectomy","volume":"16","author":"Paul","year":"2017","journal-title":"International Medical Journal Malaysia"},{"key":"2025082803275975000_12.1.e228377.2","first-page":"3","article-title":"Subcutaneous emphysema as a complication of tonsillectomy: a systematic literature review and case report","volume":"30","author":"Saravakos","year":"2018","journal-title":"Iran J Otorhinolaryngol"},{"key":"2025082803275975000_12.1.e228377.3","doi-asserted-by":"crossref","first-page":"546","DOI":"10.4103\/1012-5574.206027","article-title":"Post-tonsillectomy surgical emphysema - a case report","volume":"33","author":"Kamel","year":"2017","journal-title":"The Egyptian Journal of Otolaryngology"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-228377","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:28:07Z","timestamp":1756376887000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-228377"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1]]},"references-count":3,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,1,20]]},"published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1136\/bcr-2018-228377"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-228377","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1]]}}}