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Subcutaneous emphysema, pneumomediastinum and pneumothorax complicating laparoscopic vagotomy
Author(s) -
CHUI P. T.,
GIN T.,
CHUNG S. C. S.
Publication year - 1993
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1993.tb07479.x
Subject(s) - medicine , subcutaneous emphysema , pneumomediastinum , pneumothorax , pleural cavity , cannula , surgery , anesthesia , mediastinal emphysema , thoracic cavity
Summary Two patients developed subcutaneous emphysema and pneumomediastinum during laparoscopic vagotomy. One of the patients also had a pneumothorax which produced a sudden increase in end‐tidal carbon dioxide concentration preceding arterial oxygen desaturation. The pneumothorax was drained with an intercostal cannula. The patient required a twofold increase in minute ventilation to maintain normocarbia, probably because of the additional absorption of carbon dioxide through the pleural cavity. Despite the presence of a peritoneopleural communication, surgery was successfully completed. We believe that gas under tension in the peritoneal cavity dissected along tissue planes around the oesophagus opened up during surgery. Thus pneumomediastinum, subcutaneous emphysema and pneumothorax are definite risks associated with this new procedure.