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CASE REPORT
Year : 2020  |  Volume : 64  |  Issue : 3  |  Page : 233-235

Flickering diaphragm sign, an indicator of laparoscopy-associated pneumothorax secondary to pleural breach


1 Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
2 Department of Anesthesiology and Critical Care, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India

Correspondence Address:
Dr. Syed Nusrath
Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital, and Research Institute, Hyderabad, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ija.IJA_675_19

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During laparoscopic mobilisation of the oesophagus around hiatus in transhiatal oesophagectomy; commonly the pleura is breached causing iatrogenic pneumothorax. Often small breaches in pleura goes unnoticed till the attention is drawn by anaesthetist when pressures drop with building up of end-tidal CO2(etCO2) and other haemodynamic changes occur. We describe the flickering movements of the diaphragm associated with the pleural breach, a useful sign to alert the surgeon and anaesthetist to detect pneumothorax earlier than it is clinically evident.


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