Pneumomediastinum and pneumopericardium as rare complications after retroperitoneal transpsoas lateral lumbar interbody fusion surgery: A case report

We present the first report of rare complications (pneumomediastinum and pneumopericardium) after retroperitoneal transpsoas lateral lumbar interbody fusion (LLIF) surgery. Patient concerns: A 73-year-old female who underwent LLIF using the retroperitoneal approach complained of dysphagia but no other abnormal symptom after surgery. Diagnosis and interventions: A plain chest radiograph (CXR) taken immediately the following surgery did not show any unusual findings but CXR took on postoperative day (POD) 1 indicated pneumopericardium and pneumomediastinum with abnormal air density along the pericardium and mediastinum with subdiaphragmatic air density. A chest computed tomography revealed bilateral pleural effusion and abnormal air density (pneumopericardium and pneumomediastinum) connected to a large amount of air around the aorta and retroperitoneal space (pneumoretroperitoneum). Outcomes: The patient complained of no unusual symptom and the CXR on POD 6 indicated that no air density surrounding the mediastinum and pericardium was found. Lessons: Pneumomediastinum and pneumopericardium should be considered possible complications of LLIF using retroperitoneal transpsoas approach. Such a condition may progress to fatal conditions without early recognition and rapid management.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research