ABSTRACT
Due to smaller incisions, fewer wound injuries, and a shorter time of recovery, laparoscopic procedures are becoming increasingly popular in pediatric surgery, but the safety of their application in low-body-weight or premature infants should be a major concern. Here we present a case report of a 3-month-old premature infant, who developed a sudden change of hemodynamic instability while undergoing a laparoscopic Nissen's fundoplication for gastroesophageal reflex disease. This was thought to result from an accidental passage of massive insufflation of carbon dioxide gas across the diaphragm, leading to pneumomediastinum.
Subject(s)
Fundoplication/adverse effects , Mediastinal Emphysema/etiology , Pneumoperitoneum, Artificial/adverse effects , Hemodynamics , Humans , Infant , Infant, Premature , Laparoscopy , Male , Mediastinal Emphysema/physiopathologyABSTRACT
Tension pneumothorax is a life-threatening emergency that rapidly results in cardiopulmonary arrest. It requires prompt diagnosis and treatment. We present 2 cases from our practice, 1 caused by blunt chest trauma and the other resulting from laparoscopic surgery. Both were successfully treated by insertion of a chest tube. The diagnosis and treatment of intraoperative pneumothorax is discussed together with a review of the literature.
