Laparascopy (see Laparoscopy): CO2 insufflation into peritoneal space during the procedure may result in gas traversing diaphragm to enter the pleural space, resulting in capnothorax
Physiology
CO2 Insufflation into Peritoneal Space During Laparoscopy: gas traverses diaphragm to enter the pleural space
Clinical
Appearance of “Pneumothorax” (on CXR/Chest CT)
Dyspnea
Chest Pain
Respiratory Failure
Treatment
Observation with Supportive Care: typically resolves rapidly (within minutes-one hour) without treatment -> chest tube is typically not required
Prevention
Maintenance of Moderate-to-Low Intra-Abdominal Pressure (<12 mm Hg) During Laparoscopy: can help limit the development of capnothorax
References
Circulatory and Respiratory Complications of Carbon Dioxide Insufflation. Dig Surg 2004;21:95–105 [MEDLINE]
