Preoperative progressive pneumoperitoneum for a giant incisional hernia: report of a case with a rare complication

Vinicius Rodrigues Taranto Nunes, Rafael Calvão Barbuto, José Renan Cunha-Melo, Mario Pastore Neto, Carla Jorge Machado, Galileu Chagas Lourenço, Guilherme Nogueira Pena, Marcello Fonseca Marino, David Silveira Farias, Ingrid Bremer Toledo

Resumo


In patients with giant incisional hernias, many anatomical and physiological changes turn hernia repair into quite a challenge. The possibility of developing complications as abdominal compartment syndrome after hernioplasty has prompted surgeons to seek for technical options. A tempting alternative is to induce progressive preoperative pneumoperitoneum (PPP) aiming to adapt the organism to an increase in the abdominal content. We describe the case of a patient with giant incisional hernia submitted to PPP. The patient complicated with a very symptomatic pneumomediastinum. Despite being frequently well tolerated, it is important to make a point that the induction of PPP may result in severe complications.


Palavras-chave


pneumoperitônio artificial; enfisema mediastínico; hérnia incisional; cuidados pré-operatórios; herniorrafia.

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Referências


Mcadory RS, Cobb WS, Carbonell AM. Progressive preoperative pneumoperitoneum for hernias with loss of domain. Am Surg. 2009; 75(6):504-9.

Mayagoitia JC, Suárez D, Arenas JC, León VD. Preoperative progressive pneumoperitoneum in patients with abdominal-wall hernias. Hernia. 2006; 10:213-7. DOI: 10.1007/s10029-005-0040-8

Sanders DL, Kingsnorth AN. The modern management of incisional hernias. BMJ. 2012;344:e2843. DOI: 10.1136/bmj.e2843

Hesselink VJ, Luijendijk RW, de Wilt JH, Heide R, Jeekel. An evaluation of risk factors in incisional hernia recurrence. Surg Gynecol Obstet. 1993; 176(3):228-34.

Mudge M, Hughes LE. Incisional hernia: a 10 year prospective study of incidence, attitudes. Br J Surg. 1985;72:70-1.

Astudillo R, Merrell R, Sanchez J, Olmedo S. Ventral herniorrhaphy aided by pneumoperitoneum. Arch Surg. 1986;121(8):935-6. DOI: 10.1001/archsurg.1986.01400080081014

Swelstad J, Caprini JA. Use of progressive pneumoperitoneum in the treatment of giant abdominal hernias. Am Surg. 1978;44(6):337-41.

Goñi-Moreno I. Chronic eventration and large hernias: preoperative treatment by progressive pneumoperitoneum: original procedure. Surgery. 1947;22(6):945-53.

Caldironi MW, Romano M, Bozza F, Pluchinotta AM, Pelizzo MR, Toniato A, et al. Progressive pneumoperitoneum in the management of giant incisional hernias: a study of 41 patients. Br J Surg. 1990;77(3):306-7. DOI: 10.1002/bjs.1800770322

Johnson WC. Preoperative progressive pneumoperitoneum in the preparation for repair of large hernias of the abdominal wall. Am J Surg. 1972;124(1):63-8.

Minossi JG, Oliveira WK, Llanos JC, Ielo SM, Hasimoto CN, Pereira RSC. O uso do pneumoperitônio progressivo no pré-operatório das hérnias volumosas da parede abdominal. Arq Gastroenterol. 2009;46(2):121-6. DOI: http://dx.doi.org/10.1590/S0004-28032009000200009

Piskin T, Aydin C, Barut B, Dirican A, Kayaalp C. Preoperative progressive pneumoperitoneum for giant inguinal hernias. Ann Saudi Med. 2010;30(4):317-20. DOI: 10.4103/0256-4947.65268

Toniato A, Pagetta C, Bernante P, Piotto A, Pelizzo MR. Incisional hernia treatment with progressive pneumoperitoneum and retromuscular prosthetic hernioplasty. Langenbecks Arch Surg. 2002;387:246-8. DOI: 10.1007/s00423-002-0316-8

Raynor RW, Del Guercio LR. The place of pneumoperitoneum in the repair of massive hernia. World J Surg. 1989;13(5):581-5.

Hamer DB, Duthie HL. Pneumoperitoneum in the management of abdominal incisional hernia. Br J Surg. 1972;59(5):372-5. DOI: 10.1002/bjs.1800590510

Murdock CM, Wolff AJ, Van Geem T. Risk factors for hypercarbia, subcutaneous emphysema, pneumothorax, and pneumomediastinum during laparoscopy. Obstet Gynecol. 2000;95(5):704-9.

Richard HM 3rd, Stancato-Pasik A, Salky BA, Mendelson DS. Pneumothorax and pneumomediastinum after laparoscopic surgery. Clin Imaging. 1997;21(5):337-9.




DOI: https://doi.org/10.23925/1984-4840.2018v20i1a13

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Esta obra está licenciada sob uma licença Creative Commons Atribuição 4.0 Internacional.

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Rev. Fac. Ciênc. Méd. Sorocaba, Sorocaba, SP, Brasil, e-ISSN 1984-4840

A Revista da Faculdade de Ciências Médicas de Sorocaba está licenciada com uma Licença Creative Commons - Atribuição 4.0 Internacional.