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Pneumomediastinum After Robotic Sacrocolpopexy

Crawford, Natalie M. MD; Pathi, Sujatha D. MD; Corton, Marlene M. MD

Female Pelvic Medicine & Reconstructive Surgery: January/February 2014 - Volume 20 - Issue 1 - p 56–58
doi: 10.1097/SPV.0b013e31829098b9
Case Reports

Background Pneumomediastinum is a rare but potential complication of laparoscopy that is related to insufflation with carbon dioxide gas and may lead to life-threatening complications.

Case A 76-year-old woman underwent robotic sacrocolpopexy to repair posthysterectomy prolapse without any apparent intraoperative complications. Postoperatively, she developed shortness of breath and tachycardia and was found to have subcutaneous emphysema and pneumomediastinum.

Conclusion Pelvic surgeons should understand the risks associated with development of pneumomediastinum as well as associated signs and symptoms. In our case, pneumomediastinum likely developed as carbon dioxide tracked from the peritoneum into the mediastinum during prolonged robotic retroperitoneal surgery. Surgeons should have a low threshold to obtain radiographic tests in the early postoperative period, as close monitoring is essential to manage potentially life-threatening complications such as pneumothorax and cardiac arrest.

A case of post-operative pneumomediastinum, a rare but potentially serious complication of laparoscopy, is described.

From the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX.

Reprints: Natalie M. Crawford, MD, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75235-9032. E-mail: natalie.crawford@phhs.org.

The authors have declared that they have no conflicts of interest.

© 2014 by Lippincott Williams & Wilkins