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Case Reports
. 2023 Jan:102:107825.
doi: 10.1016/j.ijscr.2022.107825. Epub 2022 Dec 1.

A rare complication of secondary pneumothorax following exploratory laparotomy for a small bowel obstruction: Case report

Abhishek Seth  1 , Inderbir Padda  2 , Rizwan Chaudhry  3
Affiliations
Case Reports

A rare complication of secondary pneumothorax following exploratory laparotomy for a small bowel obstruction: Case report

Abhishek Seth et al. Int J Surg Case Rep. 2023 Jan.

Abstract

Introduction: Small bowel obstruction (SBO) is recognized as the most common surgical emergency following abdominal procedures. Moreover, a pneumothorax secondary to an SBO is an infrequent phenomenon less commonly reported in recent literature. Clinical presentation includes progressive dyspnea and fatigue. The diagnosis was made with imaging. In this case report, the authors present a rare case of concurrent surgical complications (pneumothorax, SBO, perforation of the stomach, and hiatal hernia).

Case presentation: A 62 years-old African American patient who presented with severe sudden onset difficulty breathing two days following laparoscopic toupet fundoplication procedure. She was given oxygen via cannula and the underwent chest tube insertion. She was then transferred to different facility under care of a cardio thoracic surgeon.

Clinical discussion: Although SBO is most common emergency following an abdominal procedure, pneumothorax is rarely reported. This case report depicts a unique presentation of pneumothorax secondary to SBO and a discussion section conferring complication risk versus benefits of diverse management modalities (surgical or conservative), and a review of recent literature, further aiding healthcare professionals in the diagnosis and management of patients with SBO complications.

Conclusion: Review of this case and the literature show a rare presentation of secondary pneumothorax following exploratory laparotomy for SBO. Recognizing the clinical signs and even a small suspicion should prompt one to order imaging. Chest X-ray is inexpensive and can rapidly rule out pneumothorax. These complications have high mortality in patients above the age of 60 years, hence, timely management is of utmost importance.

Keywords: Case report; Complication; Hiatal hernia; Incisional hernia; Laparoscopic; Secondary pneumothorax; Small bowel obstruction.

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Conflict of interest statement

Declaration of competing interest None to declare.

Figures

Fig. 1
Fig. 1
Chest X-ray of left sided pneumothorax.
Fig. 2
Fig. 2
CT-scan demonstrating pneumothorax and NG tube in thoracic cavity.
Fig. 3
Fig. 3
CT-scan demonstrating pneumothorax.
See this image and copyright information in PMC

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