Capnothorax

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A capnothorax, sometimes referred to as a carbon dioxide (CO2) pneumothorax, has been reported as a potential complication with laparoscopic surgeries.

Epidemiology

It has been reported with almost all laparoscopic surgeries and is more likely to occur with high CO2 pressures and prolonged surgery (>200 minutes) .

Clinical presentation

See the main article on pneumothorax.

Pathology

It occurs intra-operatively when the parietal pleura is breached and CO2 used in laparoscopic abdominal surgery enters the pleural space.

Etiology

There are probably many different causes :

iatrogenic
congenital diaphragmatic weakness or defect
CO2 diffusion

Radiographic features

See the main article on pneumothorax.

Treatment and prognosis

CO2 can accumulate in the pleural space resulting in a "tension capnothorax" (see: tension pneumothorax), which is life-threatening and requires immediate decompression.