{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T07:57:12Z","timestamp":1772697432710,"version":"3.50.1"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>Subcutaneous emphysema (SE) is a recognized but rare complication of laparoscopic surgery, and orbital involvement is particularly unusual. We report a rare case of unilateral orbital SE following laparoscopic hiatal hernia repair with Nissen fundoplication. A 49-year-old hypertensive woman with gastroesophageal reflux disease (GERD) underwent elective laparoscopic hiatal hernia repair. Intraoperatively, she developed sudden-onset left orbital emphysema. Imaging revealed mild left pneumothorax and bilateral pleural effusions. Orbital swelling was identified intraoperatively, prompting multidisciplinary evaluation including anesthesiology, surgery, and ophthalmology. Conservative management resulted in rapid and complete resolution within 48\u2005h, without visual or respiratory sequelae. Orbital SE following laparoscopy is uncommon but clinically significant. Risk factors include high insufflation pressure, previous abdominal surgeries, and prolonged operative time. Prompt clinical and radiological assessment ensures early diagnosis and prevents complications such as orbital compartment syndrome. Surgeons must remain vigilant for rare SE presentations after laparoscopy. Conservative management is effective in mild cases, but early multidisciplinary intervention is essential to prevent vision loss.<\/jats:p>","DOI":"10.3389\/fsurg.2026.1741472","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T06:58:23Z","timestamp":1772693903000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Unilateral orbital surgical emphysema following laparoscopic hiatal hernia repair and Nissen fundoplication: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Ahmed M.","family":"Saggaf","sequence":"first","affiliation":[{"name":"General Surgery Department, King Abdulaziz Hospital","place":["Jeddah, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan U.","family":"Al-ghamdi","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, King Fahad Hospital","place":["Al Baha, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naseer Ayed","family":"Asiri","sequence":"additional","affiliation":[{"name":"Prince Meshari Bin Saud, General Hospital","place":["Al Baha, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihdhar O.","family":"Saggaf","sequence":"additional","affiliation":[{"name":"General Surgery Department, King Abdulaziz Hospital","place":["Jeddah, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Nagi","sequence":"additional","affiliation":[{"name":"Prince Meshari Bin Saud, General Hospital","place":["Al Baha, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raneem","family":"Alathath","sequence":"additional","affiliation":[{"name":"Ibn Sina College","place":["Jeddah, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jumana H.","family":"Timraz","sequence":"additional","affiliation":[{"name":"General Medicine Practice Program, Batterjee Medical College","place":["Jeddah, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Husna","family":"Irfan Thalib","sequence":"additional","affiliation":[{"name":"General Medicine Practice Program, Batterjee Medical College","place":["Jeddah, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"17","DOI":"10.21037\/shc.2020.03.08","article-title":"Postoperative subcutaneous emphysema: prevention and treatment","volume":"5","author":"Lodhia","year":"2021","journal-title":"Shanghai Chest"},{"key":"B2","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1016\/j.ijscr.2020.11.070","article-title":"Orbital emphysema post laparoscopic Nissen fundoplication in an adult with ventriculoperitoneal shunt. 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