A lady presented in the emergency depament with a stab injury to the left side of the abdomen. She was hemodynamically stable and a contrast enhanced CT scan revealed a laceration in spleen. Laparoscopy was planned. The patient's p02 suddenly dropped as soon as the pneumoperitoneum was created. What is the most likely cause:
Ans is 'd' i.e. Gaseous embolism through splenic vessels The sudden drop in p02 during insufflation of gas for creating pneumoperitoneum suggests gas embolism from entry of the gas into the circulation through exposed vessels in the splenic tear. Gas embolism may also occur due to inadveent inseion of the trocar into a vessel or an abdominal organ.
Inferior venacava compression
Injury to the left lobe of the diaphragm
Injury to the colon
Gaseous embolism through splenic vessels