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Contralateral pneumothorax during retroperitoneal laparoscopic donor nephrectomy: A case report
Author(s) -
Matsushita Yuto,
Miyake Hideaki,
Motoyama Daisuke,
Sugiyama Takayuki,
Nagata Masao,
Otsuka Atsushi,
Furuse Hiroshi,
Ozono Seiichiro
Publication year - 2017
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12354
Subject(s) - medicine , pneumomediastinum , thoracostomy , pneumothorax , surgery , pneumoperitoneum , mediastinum , insufflation , chest tube , nephrectomy , diaphragmatic breathing , retroperitoneal space , laparoscopy , anesthesia , kidney , pathology , endocrinology , alternative medicine
This report presents a case of a 46‐year‐old woman in whom contralateral pneumothorax occurred during retroperitoneal laparoscopic donor nephrectomy without any evidence of diaphragmatic injuries. After the start of carbon dioxide‐induced pneumoperitoneum, the patient's end‐tidal carbon dioxide pressure and heart rate suddenly increased. The surgery was then paused, and a chest X‐ray revealed a right pneumothorax accompanied by pneumomediastinum. After a thoracostomy tube was inserted, these symptoms immediately improved. After conversion to an open procedure, the surgery was completed. The thoracostomy tube was removed the next day, and the patient was discharged without any complications. As the pneumothorax occurred on the opposite side to the operative field and there was no evidence of diaphragmatic injury, it is suspected to have been caused by a pneumomediastinum‐induced rupture of the barrier between the mediastinum and pleural space. This may have occurred due to the insufflated carbon dioxide gas passing directly into the mediastinum and then the pleural space.