title: Spontaneous resolution of massive right-sided pneumothorax occurring during laparoscopic cholecystectomy.
abstract: Pneumothorax is a rare but potentially serious complication that can occur during laparoscopic surgery. We describe a case of a spontaneous massive right-sided pneumothorax that occurred during laparoscopic cholecystectomy, presumably because of escape of intraperitoneal carbon dioxide under pressure into the pleural cavity through a congenital defect in the diaphragm. During the procedure, arterial oxygen saturation decreased and clinical examination revealed signs of a right-sided pneumothorax. This was confirmed on chest x-ray in the immediate postoperative period. Since the patient was clinically stable without any signs of respiratory distress, a conservative approach was adopted. The patient remained on close clinical observation and continuous monitoring of arterial hemoglobin oxygen saturation by pulse oximetry and repeat chest x-rays and had an uneventful recovery with complete resolution of the pneumothorax 3 hours after surgery and without the need for thoracic aspiration or tube thoracostomy.
authors.affiliation: Second Department of Surgery, Democritus University of Thrace, Medical School, Alexandroupolis, Greece. akarayan@usa.net
authors.forename: Anastasios J
authors.initials: AJ
authors.lastname: Karayiannakis
authors.forename: Stavros
authors.initials: S
authors.lastname: Anagnostoulis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Michailidis
authors.forename: Theodosia
authors.initials: T
authors.lastname: Vogiatzaki
authors.forename: Alexandros
authors.initials: A
authors.lastname: Polychronidis
authors.forename: Constantinos
authors.initials: C
authors.lastname: Simopoulos
mesh_terms: D000328:Adult; D002245:Carbon Dioxide; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D003964:Diaphragm / Q000002:abnormalities*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology*; D013902:Radiography, Thoracic; D012075:Remission, Spontaneous; D012449:Safety; D013525:Surgical Instruments; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002245:Carbon Dioxide