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Pneumoperitoneum Post Esophageal Stent Insertion Managed With Paracentesis.
Priyanthi Widana Pathirana1,2, Chandika Liyanage1
1Department of General Surgery, Dubbo Base Hospital, Dubbo, NSW, Australia.
Journal of Medical Cases
|April 25, 2022
Summary
Pneumoperitoneum, a complication of endoscopy, can often be managed conservatively. Paracentesis offers symptomatic relief for abdominal gas, aiding non-operative management in stable patients.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Surgical Complications
Background:
- Gastrointestinal tract perforation is a recognized complication following endoscopic procedures.
- It can manifest as pneumoperitoneum, pneumomediastinum, or subcutaneous emphysema.
- High insufflation pressures or mechanical trauma during endoscopy can lead to pneumoperitoneum.
Observation:
- A 74-year-old female developed pneumoperitoneum after esophageal stent insertion for malignant dysphagia.
- She presented with severe epigastric pain immediately post-procedure.
- Imaging confirmed pneumoperitoneum, and paracentesis was performed for pain relief.
Findings:
- The patient experienced significant pain relief following paracentesis, which decompressed intra-abdominal free gas.
- She was subsequently managed conservatively and responded well.
- This suggests that paracentesis can facilitate non-operative management of post-endoscopic pneumoperitoneum.
Implications:
- Paracentesis may serve as a valuable tool for symptomatic management of pneumoperitoneum post upper gastrointestinal endoscopy.
- It can help stabilize patients, potentially avoiding surgical intervention in select cases.
- This approach highlights the importance of considering conservative measures alongside procedural interventions for endoscopic complications.
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