Asystolic cardiac arrest: a rare complication of laparoscopy

A healthy young woman suffered cardiac arrest during diagnostic laparoscopy; emergent laparotomy was required to release the pneumoperitoneum and reinitiate cardiac rhythm. Several cases of cardiovascular collapse have been described in the literature. Possible causes for such complications include hypercapnia or anoxia from hypoventilation during anesthesia, decreased venous return and cardiac output secondary to elevated intra-abdominal pressure, gas embolism, and a profound vagal response to peritoneal distention. Treatment includes cardiovascular support and rapid release of the pneumoperitoneum.