CTICasesPost-Laparoscopic Diaphragmatic Hernia Repair Pneumoperitoneum and Pneumothorax
Imaging findings
Postoperative chest radiograph following laparoscopic paraesophageal hernia repair shows free gas under the diaphragm, pneumomediastinum, and bilateral pneumothoraces. Follow-up radiograph obtained approximately six hours later demonstrates complete, spontaneous resolution of the gas.
Key takeaways
Incidental pneumothorax and pneumomediastinum are common, self-limiting occurrences following laparoscopic diaphragmatic surgery due to the tracking of carbon dioxide gas used for insufflation. Because carbon dioxide is highly soluble and rapidly reabsorbed, conservative management without chest tube insertion is appropriate.
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