We experienced a case of pulmonary embolism following laparoscopic cholecystectomy probably due to pneumoperitonum. A 46-year-old woman, who had a laparoscopic cholecystectomy, began complaining of dyspnea about 24 hours after the operation. Blood gas analysis revealed severe hypoxemia with PaO2 level of 47.6mmHg. These physical signs and clinical data were indicative of pulmonary embolism, so anticoagulant therapy with 10, 000unit/day of heparin was initiated. Pulmonary sintigram at the onset demonstrated segmental perfusion defect of Lt. S8 and Rt. S10. After the initiation of the therapy her condition improved markedly.
A suspecion has been aroused that pneumoperitonum may induse deep vein thrombosis causing pulmonary embolism since the introduction of laparoscopic cholecystectomy. For this disease, early detection and early treatment are determinative factors for prognosis. So it should be considered as one of the most critical complications after laparoscopic surgery and cautious strategy for prevention is important in high-risk cases.