Abstract:
Pleuroperitoneal communication poses a respiratory failure risk due to pleural fluid accumulation with thoracic migration of ascites. Here, we discuss the following cases: Case 1: A woman was diagnosed with a ruptured ovarian tumor with right pleural fluid and ascites, without respiratory failure. Ovarian cystectomy was performed with inadequate removal of ascites. Postoperatively, respiratory failure occurred, and thoracentesis detected pleural fluid resembling ascites. Case 2: A woman was diagnosed with a ruptured ectopic pregnancy with right pleural fluid and ascites without respiratory failure. A diagnosis of clinical pleuroperitoneal communication was considered based on computed tomography findings. During laparoscopic salpingectomy, high-pressure ventilation was performed to push the pleural fluid back into the abdominal cavity; a negative-pressure drain was inserted, and the ascites was completely removed. Postoperative radiography revealed the absence of pleural fluid. Therefore, a preoperative diagnosis of clinical pleuroperitoneal communication and appropriate intraoperative techniques can prevent postoperative respiratory failure.
摘要:
由于胸膜积液和腹水的胸腔迁移,胸膜腹膜通讯会引起呼吸衰竭的风险。这里,我们讨论了以下病例:病例1:一名妇女被诊断为卵巢肿瘤破裂,伴有右胸膜积液和腹水,没有呼吸衰竭。卵巢囊肿切除术切除腹水不充分。术后,发生呼吸衰竭,胸腔穿刺术检测到类似腹水的胸膜液。病例2:一名妇女被诊断为异位妊娠破裂,伴有右胸膜积液和腹水,无呼吸衰竭。根据计算机断层扫描结果考虑了临床胸膜腹膜通讯的诊断。在腹腔镜输卵管切除术中,进行高压通气以将胸膜液推回腹腔;插入负压引流管,腹水被完全清除.术后X线检查显示没有胸膜液。因此,术前诊断临床胸膜-腹膜通讯和适当的术中技术可以预防术后呼吸衰竭。