{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T14:33:59Z","timestamp":1777300439938,"version":"3.51.4"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":116,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002543","name":"Pusan National University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Anesthesiology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>During laparoscopic surgery, tension pneumothorax may persist despite prompt anatomical repair of a diaphragmatic injury, posing a diagnostic and management challenge for anesthesiologists under general anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case<\/jats:title>\n                    <jats:p>A 68\u2010year\u2010old male undergoing bilateral laparoscopic adrenalectomy using a retroperitoneal approach developed progressive hypoxemia, hypercapnia, elevated peak inspiratory pressure, and hemodynamic instability approximately 4\u2009h after surgical initiation. A minor diaphragmatic injury was identified and immediately repaired after reduction of pneumoretroperitoneum. Despite anatomical correction, respiratory and circulatory instability persisted, requiring high\u2010dose vasopressor support and 100% inspired oxygen until the end of surgery. A radiograph obtained at the conclusion of surgery demonstrated marked mediastinal shift consistent with tension pneumothorax. The pneumothorax resolved spontaneously with supportive ventilation, and the patient recovered without chest tube insertion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights a physiological pitfall rather than a rare complication: even a minor diaphragmatic injury can result in sustained tension physiology despite timely anatomical repair during prolonged laparoscopic surgery. Continuous vigilance for evolving physiological abnormalities and proactive anesthesiologist\u2010led management are essential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/cria\/6594164","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T13:35:39Z","timestamp":1777296939000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Physiological Persistence of Tension Pneumothorax After Minor Diaphragmatic Injury During Laparoscopic Adrenalectomy: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7967-1127","authenticated-orcid":false,"given":"Eun Ji","family":"Park","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3527-555X","authenticated-orcid":false,"given":"Jeong-Min","family":"Hong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3450-865X","authenticated-orcid":false,"given":"Hyeon-Jeong","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2517-8396","authenticated-orcid":false,"given":"Unji","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2338-9648","authenticated-orcid":false,"given":"Wangseok","family":"Do","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"e_1_2_8_1_2","article-title":"Laparoscopic Versus Open Cholecystectomy for Patients With Symptomatic Cholecystolithiasis","author":"Keus F.","year":"2026","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000001073"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0029-7844(00)00781-x"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0889-8537(05)70213-3"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina59091631"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0300060519898048"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2020.10.032"},{"key":"e_1_2_8_8_2","article-title":"Tension Pneumothorax, is it a Really Life-Threatening Condition?","volume":"8","author":"Yoon J. S.","year":"2013","journal-title":"Journal of Cardiothoracic Surgery"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40981-023-00630-y"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004649900320"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-78375-2"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjac127"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2018.0050"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.89913"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2007.0122"}],"container-title":["Case Reports in Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cria\/6594164","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/cria\/6594164","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cria\/6594164","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T13:35:40Z","timestamp":1777296940000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/cria\/6594164"}},"subtitle":[],"editor":[{"given":"Benjamin","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/cria\/6594164"],"URL":"https:\/\/doi.org\/10.1155\/cria\/6594164","archive":["Portico"],"relation":{},"ISSN":["2090-6382","2090-6390"],"issn-type":[{"value":"2090-6382","type":"print"},{"value":"2090-6390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-12-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"6594164"}}