Pneumothorax masked by subcutaneous emphysema after laparoscopic nephrectomy.
An 81-year-old man with an enhancing upper-pole renal mass underwent laparoscopic nephrectomy via a retroperitoneal approach. Postoperatively, his systolic blood pressure declined to 72 mm Hg, and arterial blood gas analysis suggested acute respiratory acidosis. Chest radiography suggested subcutaneous emphysema, but a CT scan showed tension pneumothorax. This case illustrates the difficulties in interpretation of chest films caused by the subcutaneous air that is routinely present after laparoscopic procedures.
Stern
Jeffrey A
JA
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611-3008, USA.
Nadler
Robert B
RB
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D011030:Pneumothorax / Q000175:diagnosis* / Q000209:etiology; D013352:Subcutaneous Emphysema / Q000175:diagnosis* / Q000209:etiology