title: Capnoperitoneum During Peroral Endoscopic Myotomy-Recognition and Management: A Case Report.
abstract: Peroral endoscopic myotomy (POEM) is a minimally invasive procedure for treating esophageal achalasia. During POEM, carbon dioxide is insufflated under pressure into the esophagus and stomach, which can cause clinically significant capnoperitoneum, capnomediastinum, or capnothorax. We present a case in which gas accumulation in the abdomen during POEM had adverse effects on ventilation. Once the cause was recognized, needle decompression of the abdomen led to immediate improvement in ventilation.
authors.affiliation: From the Departments of *Anesthesiology, Perioperative and Pain Medicine, and †Surgery, Division of Minimally Invasive Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Eric
authors.initials: E
authors.lastname: Lee
authors.forename: Jay B
authors.initials: JB
authors.lastname: Brodsky
authors.forename: Homero
authors.initials: H
authors.lastname: Rivas
authors.forename: Karl
authors.initials: K
authors.lastname: Zheng
authors.forename: John G
authors.initials: JG
authors.lastname: Brock-Utne
mesh_terms: D000328:Adult; D002245:Carbon Dioxide; D003664:Decompression / Q000379:methods; D004931:Esophageal Achalasia / Q000601:surgery*; D004945:Esophagoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000209:etiology* / Q000628:therapy; D009333:Neck; D011027:Pneumoperitoneum / Q000209:etiology* / Q000628:therapy; D013352:Subcutaneous Emphysema / Q000209:etiology* / Q000628:therapy; D035441:Thoracic Wall
chemical_list: D002245:Carbon Dioxide