Tension pneumothorax during peroral endoscopic myotomy for treatment of esophageal achalasia under general anesthesia

Li, Tsung-Shih; Lee, Tsung-Yang; Liao, Kate Hsiurong

doi:10.1016/j.bjane.2014.11.020

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…To the best of our knowledge, only a few cases of tension pneumothorax during POEM have been reported. Li et al 20 reported a case of tension pneumothorax, which was secondary to esophageal rupture during POEM. Gong et al 15 and Rajmohan et al 16 reported cases of tension pneumothorax during POEM, although CO 2 was used for insufflation.…”

Section: Discussionmentioning

confidence: 99%

A rare complication: Tension pneumothorax after peroral endoscopic myotomy

Kang

Kim

2022

Int J Gastrointest Interv

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Peroral endoscopic myotomy (POEM) can be safely performed for achalasia. During POEM, gas is insufflated via the endoscope inside the submucosal tunnel. Gas-related complications often cannot be avoided because of the lack of serosa in the esophagus and the inability of the adventitia to function as a resistant barrier to gas. However, tension pneumothorax causing respiratory failure is a rare complication of POEM. Herein, we describe a 32-year-old female who developed tension pneumothorax after POEM. She showed respiratory compromise after POEM, and emergency chest radiography revealed pneumothorax with mediastinal shift. Tension pneumothorax was managed by chest tube drainage with the application of negative-suction pressure via the tube, after which her vital signs stabilized. On post-procedural day 4, the tube was removed. Our case suggests the importance of considering tension pneumothorax if respiratory compromise occurs despite oxygen administration after POEM even in the absence of immediate complications during the procedure, and performing chest radiography promptly.

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Section: Discussionmentioning

confidence: 99%

A rare complication: Tension pneumothorax after peroral endoscopic myotomy

Kang

Kim

2022

Int J Gastrointest Interv

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Severe Circulatory Collapse and Ventilatory Failure Due to Pneumothorax during Peroral Endoscopic Myotomy for Treatment of Esophageal Achalasia：A Case Report

Oshima

Yoshida

Yamazaki

et al. 2020

JJSCA

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Peroral endoscopic myotomy (POEM) is an endoscopic treatment for esophageal achalasia and uses insufflation of carbon dioxide into the esophagus to achieve good visibility. We experienced a case of pneumothorax with severe circulatory collapse and ventilatory failure during POEM. During the surgery, excessively elevated airway pressure, reduction of ventilatory volume, and hemodynamic compromise occurred. After completing insufflation of carbon dioxide, positive pressure ventilation was effective in improving the pneumothorax. Pneumothorax may have resulted from inhaled carbon dioxide leaking from the esophagus into the thoracic cavity. Pneumothorax during POEM is rare, but anesthesiologists should keep the possibility of it in mind.

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Tension pneumothorax during peroral endoscopic myotomy for treatment of esophageal achalasia under general anesthesia

Cited by 2 publications

References 12 publications

A rare complication: Tension pneumothorax after peroral endoscopic myotomy

A rare complication: Tension pneumothorax after peroral endoscopic myotomy

Severe Circulatory Collapse and Ventilatory Failure Due to Pneumothorax during Peroral Endoscopic Myotomy for Treatment of Esophageal Achalasia：A Case Report

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