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Eur J Cardiothorac Surg 2003;23:239
© 2003 Elsevier Science NL

Images in cardio-thoracic surgery

Spontaneous pneumoperitoneum after pleuroperitoneal shunt

Morris Beshay, Ralph A. Schmid*

Division of General Thoracic Surgery, University Hospital, 3010 Berne, Switzerland

Received 18 June 2002; received in revised form 22 October 2002; accepted 30 October 2002.

* Corresponding author. Tel.: +41-31-632-2330; fax: +41-31-632-2327
e-mail: ralph.schmid{at}insel.ch

Key Words: Pneumoperitoneum • Pleuroperitoneal shunt

A 42-year-old woman with stage IV bronchogenic carcinoma presented with recurrent malignant pleural effusion and trapped left lung 4 weeks after talc pleurodesis. A pleuroperitoneal (Denver®) shunt was implanted. The postoperative course was uneventful. Fifteen days later she complained of difficulties in closing her pants although she had lost weight. Chest X-ray in the upright position showed the presence of a pneumoperitoneum (Fig. 1) . The problem was solved with left pleural drainage (Fig. 2) . There was a small air leak for a few days and then the pneumoperitoneum disappeared rapidly.



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  		Fig. 1. Chest X-ray with the pneumoperitoneum and the pleuroperitoneal shunt (black arrow).

 


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  		Fig. 2. Follow-up chest X-ray after removal of the pleural drainage with minimal residual pneumoperitoneum.

 



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Massive Pneumoperitoneum: A Late Complication of the Denver Pleuroperitoneal Shunt
Ann. Thorac. Surg., October 1, 2005; 80(4): e13 - e13.
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