Extraperitoneal gas extravasation can cause which of the following complications?

Extraperitoneal gas extravasation can cause which of the following complications?

• A. Gas embolus
• B. Increased CO2 absorption
• C. Improved diaphragmatic movement
• D. Decreased subcutaneous emphysema

Answer: (A)

Extraperitoneal gas extravasation means CO2 escapes into tissue planes such as the retroperitoneum or subcutaneous tissues. If that CO2 gains access to venous channels, it can form a venous gas embolus that travels to the right heart and pulmonary circulation, causing obstruction, sudden hypoxemia, and hemodynamic instability. CO2 is highly soluble, so small amounts are absorbed easily, but a rapid entry of gas into the venous system can produce a dangerous embolic event that the patient may clinically manifest as a sudden drop in end-tidal CO2, hypotension, or hypoxemia. The other options do not describe a typical or as-probable complication of extraperitoneal gas: diaphragmatic movement is not improved by gas in these spaces, and subcutaneous emphysema is a consequence rather than a decrease, so the most concerning and characteristic complication is a gas embolism.

Extraperitoneal gas extravasation means CO2 escapes into tissue planes such as the retroperitoneum or subcutaneous tissues. If that CO2 gains access to venous channels, it can form a venous gas embolus that travels to the right heart and pulmonary circulation, causing obstruction, sudden hypoxemia, and hemodynamic instability. CO2 is highly soluble, so small amounts are absorbed easily, but a rapid entry of gas into the venous system can produce a dangerous embolic event that the patient may clinically manifest as a sudden drop in end-tidal CO2, hypotension, or hypoxemia. The other options do not describe a typical or as-probable complication of extraperitoneal gas: diaphragmatic movement is not improved by gas in these spaces, and subcutaneous emphysema is a consequence rather than a decrease, so the most concerning and characteristic complication is a gas embolism.