Pulmonary Embolism Associated With Pneumomediastinum and Pneumoperitoneum After Laparoscopic Myomectomy: A Case Report and Literature Review

Laparoscopic surgery is a common technique with a minimal risk of consequences for the treatment of gynecological conditions, including uterine leiomyomas. However, in rare instances, serious postoperative complications may occur. We present the case of a 51-year-old patient who underwent a laparoscopic myomectomy without intraoperative complications. The patient experienced acute dyspnea shortly after the surgery, in the absence of other accompanying symptoms. Pneumoperitoneum, pneumomediastinum, and pulmonary embolism (PE) were found during radiological assessment, which included both thoracic and abdominal computed tomography. This case highlights a rare but clinically significant complication that may occur following laparoscopic gynecological surgery, and, to our knowledge, represents the first attempt to suggest a strong association between the coexistence of pneumoperitoneum and pneumomediastinum and PE. Even though venous thromboembolism is still the predominant cause of PE, the potential contribution of perioperative factors warrants further investigation, with the aim of improving the understanding of underlying pathophysiological mechanisms and enhancing patient safety.