Carbon dioxide embolism in a 3-week-old neonate during laparoscopic pyloromyotomy: a case report.
Publication/Presentation Date
4-1-2009
Abstract
Laparoscopic pyloromyotomy has gained popularity in the treatment of hypertrophic pyloric stenosis. This is the first case report of carbon dioxide embolism during laparoscopic pyloromyotomy. We describe a case of carbon dioxide embolism in a 3-week-old neonate during laparoscopic pyloromyotomy by injection of carbon dioxide into a patent umbilical vein. The diagnosis of carbon dioxide embolism was made on the basis of the abrupt decrease in end-tidal CO(2), sudden decreased Spo(2), hypotension, and cyanosis. Portable x-ray with the clinical presentation was sufficient for a diagnosis of carbon dioxide embolism. Treatment included termination of CO(2) insufflation, placing the patient in Durant's position, and adequate resuscitation as necessary. Despite the fact that the insufflation pressure was in the recommended range, a carbon dioxide embolism was thought to be caused by injection of carbon dioxide into a patent umbilical vein. Although laparoscopic pyloromyotomy has demonstrated to be a safe and effective procedure, this is a serious and rare complication causing prolonged length of stay and skewed hospital charges.
Volume
44
Issue
4
First Page
842
Last Page
845
ISSN
1531-5037
Published In/Presented At
Kudsi, O. Y., Jones, S. A., & Brenn, B. R. (2009). Carbon dioxide embolism in a 3-week-old neonate during laparoscopic pyloromyotomy: a case report. Journal of pediatric surgery, 44(4), 842–845. https://doi.org/10.1016/j.jpedsurg.2008.11.045
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
19361651
Department(s)
Department of Pediatrics, Department of Surgery
Document Type
Article