Isolated tension pneumoperitoneum following endobronchial ultrasound-guided transbronchial needle aspiration complicated by cardiac peri-arrest: A case report

https://doi.org/10.4081/monaldi.2018.999

Authors

  • Piergiorgio Muriana | muriana.piergiorgio@hsr.it San Raffaele Scientific Institute, Department of Thoracic Surgery, Italy. http://orcid.org/0000-0003-1341-1071
  • Angelo Carretta San Raffaele Scientific Institute, Department of Thoracic Surgery, Italy.
  • Paola Ciriaco San Raffaele Scientific Institute, Department of Thoracic Surgery, Italy.
  • Francesca Rossetti San Raffaele Scientific Institute, Department of Thoracic Surgery, Italy.
  • Giampiero Negri San Raffaele Scientific Institute, Department of Thoracic Surgery, Italy.

Abstract

Transbronchial needle aspiration under endobronchial ultrasound guidance (EBUS-TBNA) is recommended for the diagnosis and staging of lung cancer. Major complications following EBUS-TBNA are uncommon. We report a case of isolated tension pneumoperitoneum following EBUS-TBNA under deep sedation in an 80-year-old male patient affected by a right hilar mass suspicious for lung cancer. At the end of the procedure, the patient suddenly manifested desaturation, severe bradycardia and hypotension, and abdominal distension. After resuscitation, in the suspect of intraperitoneal free air, needle decompression led to respiratory and hemodynamic improvement. A total body CT-scan showed isolated pneumoperitoneum without signs of gastrointestinal perforation, confirmed by a subsequent upper digestive contrast study. The patient recovered well without the need of surgical exploration. Isolated tension pneumoperitoneum can be an exceptional complication of EBUS-TBNA; a conservative treatment can avoid unnecessary surgery in the absence of peritonism.

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Published
2018-12-12
Info
Issue
Section
Pneumology - Case Reports
Keywords:
EBUS, sedation, pneumoperitoneum, complication, conservative treatment.
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How to Cite
Muriana, Piergiorgio, Angelo Carretta, Paola Ciriaco, Francesca Rossetti, and Giampiero Negri. 2018. “Isolated Tension Pneumoperitoneum Following Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Complicated by Cardiac Peri-Arrest: A Case Report”. Monaldi Archives for Chest Disease 88 (3). https://doi.org/10.4081/monaldi.2018.999.

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