Open AccessFlickering diaphragm sign, an indicator of laparoscopy-associated pneumothorax secondary to pleural breach
Author(s) -
Syed Nusrath,
Sujit Chyau Patnaik,
Asiel Christopher,
Ajesh Raj Saksena,
Subramanyeshwar Rao Thammineedi,
R Pratap Reddy
Publication year - 2020
Publication title -
indian journal of anaesthesia/indian journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.645
H-Index - 30
eISSN - 0976-2817
pISSN - 0019-5049
DOI - 10.4103/ija.ija_675_19
Subject(s) - medicine , pneumothorax , diaphragm (acoustics) , laparoscopy , sign (mathematics) , surgery , physics , mathematics , acoustics , loudspeaker , mathematical analysis
During laparoscopic mobilisation of the oesophagus around hiatus in transhiatal oesophagectomy; commonly the pleura is breached causing iatrogenic pneumothorax. Often small breaches in pleura goes unnoticed till the attention is drawn by anaesthetist when pressures drop with building up of end-tidal CO 2 (etCO2) and other haemodynamic changes occur. We describe the flickering movements of the diaphragm associated with the pleural breach, a useful sign to alert the surgeon and anaesthetist to detect pneumothorax earlier than it is clinically evident.