Open AccessIsolated tension pneumoperitoneum following endobronchial ultrasound-guided transbronchial needle aspiration complicated by cardiac peri-arrest: A case report
Author(s) -
Piergiorgio Muriana,
Angelo Carretta,
Paola Ciriaco,
Francesca Rossetti,
Giampiero Negri
Publication year - 2018
Publication title -
monaldi archives for chest disease. pulmonary series/monaldi archives for chest disease/monaldi archives for chest disease. cardiac series
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.196
H-Index - 46
eISSN - 2465-101X
pISSN - 1122-0643
DOI - 10.4081/monaldi.2018.999
Subject(s) - medicine , pneumoperitoneum , surgery , cardiopulmonary resuscitation , paracentesis , radiology , lung cancer , perforation , complication , anesthesia , resuscitation , laparoscopy , ascites , materials science , punching , metallurgy
Transbronchial needle aspiration under endobronchial ultrasound guidance (EBUS-TBNA) is recommended for the diagnosis and staging of lung cancer. Major complications following EBUS-TBNA are uncommon. We report a case of isolated tension pneumoperitoneum following EBUS-TBNA under deep sedation in an 80-year-old male patient affected by a right hilar mass suspicious for lung cancer. At the end of the procedure, the patient suddenly manifested desaturation, severe bradycardia and hypotension, and abdominal distension. After resuscitation, in the suspect of intraperitoneal free air, needle decompression led to respiratory and hemodynamic improvement. A total body CT-scan showed isolated pneumoperitoneum without signs of gastrointestinal perforation, confirmed by a subsequent upper digestive contrast study. The patient recovered well without the need of surgical exploration. Isolated tension pneumoperitoneum can be an exceptional complication of EBUS-TBNA; a conservative treatment can avoid unnecessary surgery in the absence of peritonism.