[A case of an infant who developed pneumothorax during laparoscopic gastroesophageal antireflux surgery].

Pneumothorax is a complication associated with laparoscopic surgery, but there have been few reports of this complication in the pediatric population. We experienced a case of 7-month-old girl who developed pneumothorax during laparoscopic gastroesophageal antireflux surgery. After induction of general anesthesia, the trachea was intubated with a 3.5 mm internal diameter tube without a cuff. Anesthesia was maintained with sevoflurane and intermittent bolus injections of fentanyl. The insufflation pressure of carbon dioxide was 6 mmHg. Approximately 2 hours after the start of surgery, the intra-abdominal pressure suddenly increased to above 30 mmHg followed by a decrease in Sp(O2) to below 80%. We increased FI(O2) to 1.0 and ventilated lungs by bag. Sp(O2) recovered to 98%, but the Et(CO2) increased above 50 mmHg. Fifteen minutes after the episode, the pleural injury was found. The injured diaphragm was then repaired, and the trachea was extubated after surgery uneventfully. The pneumothorax resolved on the next day.