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Post-laparoscopic Shoulder Pain Management: A Narrative Review.

Curr Pain Headache Rep

January 2025

Department of Anesthesiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, People's Republic of China.

Purpose Of Review: Post-laparoscopic shoulder pain (PLSP) can slow patient recovery and extend hospital stays, making its management crucial for patients undergoing laparoscopic surgery. Current consensus guidelines say little about how to prevent or manage PLSP. In this context, a multimodal approach to PLSP management that maybe extend beyond the pharmaceutical interventions currently employed.

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Endometriosis presenting as catamenial pneumothorax, pneumopericardium and pneumoperitoneum.

BMJ Case Rep

January 2025

Pulmonary Medicine, K S Hegde Medical Academy, Mangaluru, Karnataka, India

A nulliparous woman in her late 30s with a history of pericardial patch repair for atrial septal defect and completed treatment for pulmonary tuberculosis 9 years ago presented with chest pain, breathlessness and abdominal pain. Radiological imaging revealed right-sided pneumothorax, pneumopericardium and pneumoperitoneum for which an intercostal drain (ICD) was placed. A contrast-enhanced CT of the abdomen showed a distal stomach perforation, which was managed conservatively.

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This review presents current opinions on an uncommon condition called catamenial pneumothorax (CP), which is usually associated with thoracic endometriosis syndrome (TES). TES is characterized by the presence of endometriotic lesions in pleura and lung parenchyma and presents with various clinical signs and symptoms, including catamenial pneumothorax. Their diagnosis is often delayed.

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Pneumoperitoneum, or free air in the peritoneal cavity, typically indicates visceral organ perforation requiring urgent surgical intervention. In peritoneal dialysis (PD) patients, however, it can occur without prior surgery or trauma, often due to technical errors, and may mimic peritonitis, risking misdiagnosis and unnecessary treatment. We report a case of a 73-year-old male PD patient presenting with fever, abdominal pain, and bowel ileus, initially raising concerns for organ perforation due to pneumoperitoneum.

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Pneumatosis cystoides intestinalis can present with concurrent diaphragmatic cysts, a previously undocumented phenomenon. Surgical management may be required, but further investigation is needed to understand the pathogenesis and optimize management in atypical and chronic cases, such as this case with a history of corrected intestinal malrotation.

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