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

Submitted: September 25, 2018
Accepted: December 3, 2018
Published: December 12, 2018
Abstract Views: 886
PDF: 617
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Authors

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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Piergiorgio Muriana, San Raffaele Scientific Institute, Department of Thoracic Surgery
Department of Thoracic Surgery

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.