Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia, USA.
Am J Gastroenterol. 2021 Feb 1;116(2):407-410. doi: 10.14309/ajg.0000000000000998.
Per-oral endoscopic myotomy (POEM) is an effective modality for the management of achalasia. Tension pneumoperitoneum is a significant complication that causes hemodynamic instability, generally within the periprocedural period.
Here, we report 2 cases of delayed tension pneumoperitoneum that was recognized and treated several hours after uncomplicated POEM.
These cases illustrate the importance of continued vigilance for this complication outside of the immediate periprocedural period as well as the utility of computed tomography-guided aspiration in managing it.
When discharging patients after POEM, caregivers should be aware of this rare complication and alert patients to return for immediate care when it happens.
经口内镜下肌切开术（POEM）是治疗贲门失弛缓症的有效方法。张力性气腹是一种严重的并发症，会导致血流动力学不稳定，通常发生在围手术期内。
在这里，我们报告了 2 例延迟性张力性气腹的病例，这些病例在 POEM 后数小时才被发现并得到治疗。
这些病例说明了在围手术期之外对这种并发症保持持续警惕的重要性，以及 CT 引导下抽吸在治疗中的作用。
在 POEM 后为患者办理出院时，护理人员应该意识到这种罕见的并发症，并告知患者在发生这种情况时立即返回接受治疗。
