Respiration and circulation affected by gas leakage into the abdominal cavity during endoscopic esophageal submucosal dissection after gastrostomy: a case report
Abstract Background Pneumoperitoneum is a common complication of percutaneous endoscopic gastrostomy (PEG). We report a case of circulatory and respiratory depression due to pneumoperitoneum caused by PEG dislodgement during endoscopic submucosal dissection (ESD) surgery. Case presentation A 46-year...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-01-01
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| Series: | JA Clinical Reports |
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| Online Access: | https://doi.org/10.1186/s40981-021-00492-2 |
| _version_ | 1798034554006536192 |
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| author | Jun Honda Keisuke Kuwana Saori Kase Shinju Obara Satoki Inoue |
| author_facet | Jun Honda Keisuke Kuwana Saori Kase Shinju Obara Satoki Inoue |
| author_sort | Jun Honda |
| collection | DOAJ |
| description | Abstract Background Pneumoperitoneum is a common complication of percutaneous endoscopic gastrostomy (PEG). We report a case of circulatory and respiratory depression due to pneumoperitoneum caused by PEG dislodgement during endoscopic submucosal dissection (ESD) surgery. Case presentation A 46-year-old man with PEG for dysphagia underwent ESD for esophageal cancer under general anesthesia. The patient developed a gradual increase in peak inspiratory pressure, followed by a decrease in peripheral oxygen saturation (SpO2) and blood pressure, as well as an increase in heart rate (HR) during endoscopic submucosal ESD for esophageal cancer. We suspected mediastinal emphysema due to esophageal perforation, but the surgery was successfully completed. Postoperative computed tomography (CT) revealed that the abdominal and gastric walls, which had been fixed by PEG, were detached, resulting in a large amount of intra-abdominal gas and mediastinal emphysema. Conclusions ESD in patients with PEG should be performed carefully because of the possibility of intraoperative PEG dislodgement and pneumoperitoneum caused by insufflation gas leakage. |
| first_indexed | 2024-04-11T20:44:55Z |
| format | Article |
| id | doaj.art-f7e9574b2f494d0f844e7288de485a41 |
| institution | Directory Open Access Journal |
| issn | 2363-9024 |
| language | English |
| last_indexed | 2024-04-11T20:44:55Z |
| publishDate | 2022-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj.art-f7e9574b2f494d0f844e7288de485a412022-12-22T04:04:04ZengSpringerOpenJA Clinical Reports2363-90242022-01-01811410.1186/s40981-021-00492-2Respiration and circulation affected by gas leakage into the abdominal cavity during endoscopic esophageal submucosal dissection after gastrostomy: a case reportJun Honda0Keisuke Kuwana1Saori Kase2Shinju Obara3Satoki Inoue4Department of Anesthesiology, Fukushima Medical University HospitalDepartment of Anesthesiology, Fukushima Medical University HospitalDepartment of Anesthesiology, Fukushima Medical University HospitalSurgical Operation Department, Fukushima Medical University HospitalDepartment of Anesthesiology, Fukushima Medical University HospitalAbstract Background Pneumoperitoneum is a common complication of percutaneous endoscopic gastrostomy (PEG). We report a case of circulatory and respiratory depression due to pneumoperitoneum caused by PEG dislodgement during endoscopic submucosal dissection (ESD) surgery. Case presentation A 46-year-old man with PEG for dysphagia underwent ESD for esophageal cancer under general anesthesia. The patient developed a gradual increase in peak inspiratory pressure, followed by a decrease in peripheral oxygen saturation (SpO2) and blood pressure, as well as an increase in heart rate (HR) during endoscopic submucosal ESD for esophageal cancer. We suspected mediastinal emphysema due to esophageal perforation, but the surgery was successfully completed. Postoperative computed tomography (CT) revealed that the abdominal and gastric walls, which had been fixed by PEG, were detached, resulting in a large amount of intra-abdominal gas and mediastinal emphysema. Conclusions ESD in patients with PEG should be performed carefully because of the possibility of intraoperative PEG dislodgement and pneumoperitoneum caused by insufflation gas leakage.https://doi.org/10.1186/s40981-021-00492-2Percutaneous endoscopic gastrostomyEndoscopic submucosal dissectionPneumoperitoneumInsufflation gas leakage |
| spellingShingle | Jun Honda Keisuke Kuwana Saori Kase Shinju Obara Satoki Inoue Respiration and circulation affected by gas leakage into the abdominal cavity during endoscopic esophageal submucosal dissection after gastrostomy: a case report JA Clinical Reports Percutaneous endoscopic gastrostomy Endoscopic submucosal dissection Pneumoperitoneum Insufflation gas leakage |
| title | Respiration and circulation affected by gas leakage into the abdominal cavity during endoscopic esophageal submucosal dissection after gastrostomy: a case report |
| title_full | Respiration and circulation affected by gas leakage into the abdominal cavity during endoscopic esophageal submucosal dissection after gastrostomy: a case report |
| title_fullStr | Respiration and circulation affected by gas leakage into the abdominal cavity during endoscopic esophageal submucosal dissection after gastrostomy: a case report |
| title_full_unstemmed | Respiration and circulation affected by gas leakage into the abdominal cavity during endoscopic esophageal submucosal dissection after gastrostomy: a case report |
| title_short | Respiration and circulation affected by gas leakage into the abdominal cavity during endoscopic esophageal submucosal dissection after gastrostomy: a case report |
| title_sort | respiration and circulation affected by gas leakage into the abdominal cavity during endoscopic esophageal submucosal dissection after gastrostomy a case report |
| topic | Percutaneous endoscopic gastrostomy Endoscopic submucosal dissection Pneumoperitoneum Insufflation gas leakage |
| url | https://doi.org/10.1186/s40981-021-00492-2 |
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