Bilateral Pneumothorax, Pneumoperitoneum and Pneumomediastinum: Anesthetic Approach of Rare ERCP Complications

Authors

  • Solange Amaro Interna Formação Específica em Anestesiologia no Serviço de Anestesiologia, Reanimação e Terapêutica da Dor, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
  • Teresa Estevens Interna Formação Específica em Anestesiologia no Serviço de Anestesiologia, Reanimação e Terapêutica da Dor, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
  • Andreia Puga Especialista em Anestesiologia no Serviço de Anestesiologia, Reanimação e Terapêutica da Dor, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal

DOI:

https://doi.org/10.25751/rspa.14299

Keywords:

Anesthesia, Cholangiopancreatography, Endoscopic Retrograde/adverse effects, Deep Sedation, Duodenum/injuries, Intubation, Intratracheal, Mediastinal Emphysema, Pneumoperitoneum, Pneumothorax

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is an increasingly used diagnostic and treatment procedure. Although rare, some complications resulting from this technique can have serious consequences for the patient, requiring early detection and systematized approach by the anesthesiologist.

The clinical case presented refers to a patient of 47 years submitted to elective ERCP by choledocholithiasis, under sedation with propofol. The exam was complicated by a false duodenal tract leading to a bilateral pneumothorax, subcutaneous emphysema, pneumoperitoneum and pneumomediastinum requiring emergent orotracheal intubation and management of the complications. The patient was transferred to the intensive care unit for surveillance under conservative measures. There was a subsequent need for surgical intervention for sepsis with an abdominal starting point.

This article aims to emphasize the importance of the presence of the anesthetist during ERCP, reviewing the patient's approach to a rare clinical picture and with important implications for morbidity and mortality.

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Published

2018-07-18

How to Cite

Amaro, S., Estevens, T., & Puga, A. (2018). Bilateral Pneumothorax, Pneumoperitoneum and Pneumomediastinum: Anesthetic Approach of Rare ERCP Complications. Journal of the Portuguese Society of Anesthesiology, 27(2), 37–40. https://doi.org/10.25751/rspa.14299

Issue

Vol. 27 No. 2 (2018)

Section

Case Report

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