Tension pneumoperitoneum after surgery for endometrial cancer and hernia in a morbidly obese female: A case report

Bing Sheng Lin, Yan Shen Shan, Wan Chen Liu, Chin Han Wu, Pei Ying Wu, Keng Fu Hsu

研究成果: Article

摘要

Background: Obesity is a risk factor for the development of endometrial cancer and abdominal wall hernias. We report a case of tension pneumoperitoneum that developed after gynecological surgery and mesh repair of a ventral hernia. Case presentation: A 57-year-old Asian Taiwanese woman with a body mass index of 52.9 (kg/m2) underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy due to endometrial cancer, and ventral herniorrhaphy with mesh due to ventral hernia. Tension pneumoperitoneum with severe dyspnea developed on postoperative day 14. Rather than performing emergency laparotomy as in visceral perforation, a transabdominal catheter was inserted to drain the intra-abdominal gas. This approach dramatically relieved the tension pneumoperitoneum and dyspnea. Our patient then recovered smoothly; the catheter was removed on postoperative 24, and she was discharged on postoperative day 28. The clinical course of the endometrial cancer and repaired ventral hernia was well at the 1-year follow-up. Conclusions: Tension pneumoperitoneum, which may result from the valve effect of unhealed abdominal mesh, could develop after gynecological surgery and hernia mesh repair in obese patients. Under these conditions, emergency drainage of the intra-abdominal gas by catheter insertion is sufficient to relieve the abdominal pressure and correct the conditions, while emergency laparotomy as in visceral perforation is unnecessary and may increase patient morbidities.

原文English
文章編號73
期刊Journal of Medical Case Reports
12
發行號1
DOIs
出版狀態Published - 2018 三月 20

    指紋

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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