Pneumothorax during laparoscopic Nissen fundoplication

Devanand Mangar, Gary T. Kirchhoff, Jorge J. Leal, Richard Laborde, Eugene Fu

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

We present a case of 100% pneumothorax in a 41-yr-old man with a history of gastritis and gastroesophageal reflux scheduled for Nissen fundoplication. The patient was anaesthetized, and insufflation of the abdominal cavity with carbon dioxide was performed uneventfully. There was an increase in the peak inspiratory pressure and wheezing was noted with a decrease in the arterial oxygen saturation to 91%. An obstructive pattern was noted on the end tidal carbon dioxide monitor. The patient also had decreased breath sounds in the left lung field. The endotracheal tube was withdrawn 1.5 cm with equal breath sounds noted in both lung fields, but the wheezing persisted. At the end of the case the trocars were removed and the abdomen was deflated. The arterial oxygen saturation increased to 94% while breathing FIO2 of 1.0. A chest roentgenogram showed a 100% left pneumothorax. A left chest tube was placed with immediate improvement of the arterial oxygen saturation to 100%. We recommend monitoring of arterial oxygen saturation, peak inspiratory pressures, and excursion of the chest for early diagnosis and prompt treatment of pneumothorax during laparoscopic procedures.

Original languageEnglish
Pages (from-to)854-856
Number of pages3
JournalCanadian Journal of Anaesthesia
Volume41
Issue number9
DOIs
StatePublished - Sep 1 1994
Externally publishedYes

Fingerprint

Fundoplication
Pneumothorax
Oxygen
Respiratory Sounds
Carbon Dioxide
Thorax
Pressure
Chest Tubes
Lung
Insufflation
Abdominal Cavity
Gastritis
Gastroesophageal Reflux
Surgical Instruments
Abdomen
Early Diagnosis
Respiration
Therapeutics

Keywords

  • complications: pneumothorax
  • surgery: laparoscopy

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Pneumothorax during laparoscopic Nissen fundoplication. / Mangar, Devanand; Kirchhoff, Gary T.; Leal, Jorge J.; Laborde, Richard; Fu, Eugene.

In: Canadian Journal of Anaesthesia, Vol. 41, No. 9, 01.09.1994, p. 854-856.

Research output: Contribution to journalArticle

Mangar, D, Kirchhoff, GT, Leal, JJ, Laborde, R & Fu, E 1994, 'Pneumothorax during laparoscopic Nissen fundoplication', Canadian Journal of Anaesthesia, vol. 41, no. 9, pp. 854-856. https://doi.org/10.1007/BF03011593
Mangar, Devanand ; Kirchhoff, Gary T. ; Leal, Jorge J. ; Laborde, Richard ; Fu, Eugene. / Pneumothorax during laparoscopic Nissen fundoplication. In: Canadian Journal of Anaesthesia. 1994 ; Vol. 41, No. 9. pp. 854-856.
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