[Unexpected hydrothorax occurring after a long gynecological laparoscopic surgery--a case report]

We experienced a case of the hydrothorax occurring after a long gynecologic laparoscopical surgery. The patient was a 36-year-old woman, weighing 51 kg and 151 cm in height. She had received a gynecological laparoscopy with no complication 5 years before. She showed no abnormalities in the preoperative examinations. The operative course was uneventful. Upon completion of the surgery, we examined the chest X-ray, and found the hydrothorax in the right thoracic cavity. A 16 gauge Angiocath was inserted into the 4th intercostal space, and found 770 ml of fluid containing saline solution, which had been used for irrigating around the uterus. We presumed the saline, which was withdrawn from the right thoratic space, had originated from vertebrocostal trigone in the diaphragm. Because blood gas data were improving, the tracheal tube was extubated. We emphasise that the routine chest X-ray examination is necessary after pneumoperitoneum of long duration.