Gas extravasation complicating laparoscopic extraperitoneal inguinal hernia repair

Surgical Endoscopy
E J HagopianD B Earle

Abstract

Carbon dioxide can extravasate from the abdominal cavity during insufflation and result in pneumomediastinum, pneumothorax, and subcutaneous emphysema. We report a case of unilateral pneumothorax with pneumomediastinum and subcutaneous emphysema after laparoscopic extraperitoneal bilateral inguinal hernia repair. Additionally, we discuss the pathophysiology, diagnostic work-up, and management of this malady. Because of the natural resolution of CO2 pneumothoraces, observation for asymptomatic patients is appropriate, whereas tube thoracostomy should be reserved for symptomatic patients. It is utmost importance to determine the etiology of gas extravastion and consider other complications such as airway or esophageal injury or pulmonary barotrauma.

Citations

May 18, 2005·Journal of Clinical Anesthesia·Tonine BartelmaosDan Benhamou
Feb 10, 2004·The Journal of Urology·Bradley J WatermanMichael Grasso
Jun 22, 2007·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Sven Christian Schmidt, Jan M Langrehr
Jul 18, 2019·Hernia : the Journal of Hernias and Abdominal Wall Surgery·M E GiménezL De Cola

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