Capnothorax During Laparoscopy in Trendelenburg Position: A Rare Case Study

Authors

  • Ana Margarida Damas Department of Anaesthesiology. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa.
  • Fátima Gonçalves Department of Anaesthesiology. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Lisboa.
  • Marisa Antunes Anestesi Operasjons Avdelingen. Universitetssykehuset Nor-Norge. Tromsø.
  • Sónia Barata Department of Obstetrics. Gynecology and Medicine of Reproduction. Centro Hospitalar Lisboa Norte. Lisboa.

DOI:

https://doi.org/10.20344/amp.11606

Keywords:

Head-Down Tilt/adverse effects, Laparoscopy, Pneumothorax/etiology, Positive-Pressure Respiration

Abstract

Pneumothorax is an infrequent complication of laparoscopic surgery. Most cases occur during upper abdominal surgery, since a head-down position (Trendelenburg) pushes the liver and peritoneum against the diaphragm, reducing gas release. When it is due to CO2 diffusion across congenital diaphragmatic defects, it usually resolves itself spontaneously after de-insufflation of the pneumoperitoneum. Increasing positive end-expiratory pressure to counteract intra-abdominal pressure is an effective measure when a pulmonary origin is excluded. We report a case of right-sided hypertensive capnothorax due to a diaphragmatic defect, during lower abdominal surgery, which was successfully managed without the need for chest drainage. This case highlights the importance of maintaining active vigilance and a high index of suspicion for pneumothorax during laparoscopic surgery. 

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Published

2020-03-02

How to Cite

1.
Damas AM, Gonçalves F, Antunes M, Barata S. Capnothorax During Laparoscopy in Trendelenburg Position: A Rare Case Study. Acta Med Port [Internet]. 2020 Mar. 2 [cited 2023 Feb. 8];33(3):202-3. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/11606

Issue

Section

Case Report