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Tension pneumopericardium during laparoscopy for trauma
G A Howells1, M R Uzieblo, H Bair
1Division of Trauma Surgery, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
Summary
This case study highlights a rare complication of laparoscopic surgery: tension pneumopericardium. A patient with thoracoabdominal stab wounds experienced hemodynamic collapse due to this condition.
Area of Science:
- Trauma Surgery
- Minimally Invasive Surgery
- Cardiothoracic Surgery
Background:
- Multiple stab wounds to the thoracoabdomen present complex diagnostic and management challenges.
- Laparoscopy is a valuable tool for assessing peritoneal penetration in trauma cases.
- Rare complications can arise even with minimally invasive surgical techniques.
Observation:
- A patient with thoracoabdominal stab wounds underwent laparoscopy to evaluate for peritoneal penetration.
- During the procedure, the patient developed hemodynamic collapse.
- The collapse was attributed to tension pneumopericardium, a buildup of air in the pericardial sac.
Findings:
- A 15 mm Hg pneumoperitoneum, established during laparoscopy, led to tension pneumopericardium.
- Tension pneumopericardium caused a critical decrease in blood flow and pressure.
- This case underscores the potential for iatrogenic complications in trauma laparoscopy.
Implications:
- Surgeons must be vigilant for rare complications like tension pneumopericardium during laparoscopic procedures.
- Prompt recognition and management of tension pneumopericardium are crucial for patient survival.
- This case contributes to the literature on managing thoracoabdominal trauma and its surgical sequelae.
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