Massive pneumomediastinum and pneumoperitoneum during peroral endoscopic myotomy

  • Govind R. Rajan 333 City Blvd. West, Suite 2150 Orange, CA 92868, USA.
  • Taizoon Q. Dhoon 333 City Blvd. West, Suite 2150 Orange, CA 92868, USA.
  • Wei-Chen Ln 333 City Blvd. West, Suite 2150 Orange, CA 92868, USA.
  • Douglas Vaughn 333 City Blvd. West, Suite 2150 Orange, CA 92868, USA.
DOI: https://doi.org/10.35975/apic.v25i5.1635
Keywords: Pneumomediastinum, Mediastinal emphysema, Subcutaneous emphysema, Hypercapnia, Pneumoperitoneum, Endoscopy, Esophagogastroduodenoscopy, Peroral endoscopic myotomy, POEM

Abstract

Peroral endoscopic myotomy (POEM) is a minimally invasive, and newly developed endoscopic intervention for esophageal achalasia. This technique has replaced open surgical techniques in centers, where expertise is available. It is comparatively a new procedure, so our knowledge about its short term and long term complications is yet very limited. We present a case of a patient undergoing POEM who suffered from hemodynamic collapse due to pneumomediastinum and massive pneumoperitoneum requiring emergent needle decompression.

Abbreviations: POEM – Peroral endoscopic myotomy; TV – Tidal volume; PEEP – Positive end-expiratory pressure; PIP – Peak inspiratory pressure; PACU – Post-operative care unit

Key words: Pneumomediastinum; Mediastinal emphysema; Subcutaneous emphysema; Hypercapnia; Pneumoperitoneum; Endoscopy; Esophagogastroduodenoscopy; Peroral endoscopic myotomy; POEM

Citation: Dhoon TQ, Ln WC, Rajan GR, Vaughn D. Massive pneumomediastinum and pneumoperitoneum during peroral endoscopic myotomy. Anaesth. pain intensive care 2021;25(5):_; DOI: 10.35975/apic.v25i5.1635

Received: Apr 09, 2021, Reviewed: Jun 26, 2021, Accepted: Jun 29, 2021

Published
09-30-2021
How to Cite
Rajan, G., Dhoon, T., Ln, W.-C., & Vaughn, D. (2021). Massive pneumomediastinum and pneumoperitoneum during peroral endoscopic myotomy. Anaesthesia, Pain & Intensive Care, 25(5), 672-675. https://doi.org/10.35975/apic.v25i5.1635
Issue
Vol 25 No 5 (2021): September-October
Section
Case Reports

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