[Pneumothorax during laparoscopic adrenal surgery: a case report].
A 55-year-old female patient was scheduled for laparoscopic adrenal surgery. In the operating room, anesthesia was induced with propofol and maintained with nitrous oxide/sevoflurane and epidural anesthesia. The operation was completed uneventfully. After tracheal extubation, Spo2 decreased suddenly from 98 to 92% and chest auscultation revealed weaker breathing sound on the left side. Left pneumothorax and pneumomediastinum were noticed on a chest X-ray. The pneumothorax in this case was thought to have been caused by passage of insufflation gas through the retroperitoneum to the mediastinum and thoracic cavity or by a minor injury of diaphragm. Although pneumothorax complication in laparoscopic surgery is rare, the frequency of its occurrence in laparoscopic adrenal surgery appears to be higher than other laparoscopic operations and may be due to the organ's location in the retroperitoneum near the diaphragm. Attention should be paid to the possibility of pneumothorax occurring during laparoscopic adrenal surgery even if there is no apparent surgical injury.
D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology*