Unexpected tension Pneumothorax occurring in an elderly patient in the post Anesthesia Care Unit

Du, Jinguang; Zuo, Yunxia
July 2011
Pakistan Journal of Medical Sciences;Jul2011, Vol. 27 Issue 4, p906
Academic Journal
Tension pneumothorax presents as a medical emergency since it spreads rapidly, disturbs the respiratory and hemodynamic functions and may be complicated by subcutaneous emphysema.Here, we report a case of an acute pneumothorax, pneumomediastinum and widespread subcutaneous emphysema that occurred unexpectedly in a 76 year old man, five minutes after his transfer to the Post Anesthesia Care Unit (PACU) following an uneventful general anesthesia for elective cholecystectomy. The main cause of the pneumothorax is believed to be rupturing of pulmonary alveoli, which might have been associated with an abrupt increase in thoracic cavity pressure. Prompt diagnosis and insertion of an underwater-seal chest drainage produced immediate recovery. The patient was sent back to his room within twenty minutes after the event and was discharged from the hospital seven days later. Anesthesiologists should be aware of the occurrence of pneumothorax in the PACU, regardless of which surgical procedure, patient population, or induction situation is associated with the event.


Related Articles

  • Recovery from anaesthesia. Lunn, John N. // BMJ: British Medical Journal (International Edition);3/26/94, Vol. 308 Issue 6932, p804 

    Emphasizes the clinical problems associated with recovery from anaesthesia in Great Britain. Importance of recovery room for surgical patients; Advantages of post anaesthesia care unit; Identification of the preventive aspects of care in the recovery room .

  • A frightening complication of general anaesthesia for paediatric dental extractions. Kumar, D.; Farrell, T.; Tierney, E. // Pediatric Surgery International;Jun2007, Vol. 23 Issue 6, p613 

    We report a case of eight year old child who developed severe subcutaneous emphysema, bilateral pneumothorax, pneumomediastinum and pneumoperitonium in recovery room after apparently uneventful general anaesthesia for eight primary teeth extractions. Causes and treatment of these complications...

  • Prediction of Effective Post-Operative Epidural Anesthesia Using Hemodynamic Changes Detected by Endotracheal Cardiac Output Monitor (ECOM). Ahlgren, Bryan; Puskas, Ferenc; Dingmann, Colleen; Seres, Tamas // Internet Journal of Anesthesiology;2012, Vol. 30 Issue 4, p1 

    Background: Epidural anesthesia after abdominal surgery results in improved postoperative pain relief but has up to a 30% failure rate. Hemodynamic changes after epidural administration of local anesthetics may provide parameters to predict dermatomal blockade and effective pain control in the...

  • Comparison of the effects of intravenously administered dexmedetomidine with clonidine on hemodynamic responses during laparoscopic cholecystectomy. Hazra, Rajdip; Manjunatha, S M; Babrak Manuar, M D; Basu, Rajarshi; Chakraborty, Sisir // Anaesthesia, Pain & Intensive Care;Jan-Mar2014, Vol. 18 Issue 1, p25 

    Background: Clonidine, a selective alpha-2 adrenergic agonist, and dexmedetomidine, a new generation highly selective alpha-2 adrenoreceptor agonist, are well known to inhibit catecholamine release. The present study compares the effects of intravenously administered clonidine versus...

  • Patients with partners.  // Cortlandt Forum;01/25/97, Vol. 10 Issue 1, p98 

    Details a physician's experience with patients who had suffered spontaneous pneumomediastinum or pneumothorax. Claims by patient's partner of having heard the patient's heart beating through the chest wall at the time of the pain as the key to the diagnosis.

  • Perioperative effects of various anesthetic adjuvants with TIVA guided by bispectral index. Khafagy, Hanan F.; Ebied, Reeham S.; Osman, Emad S.; Ali, Mohamed Z.; Samhan, Yasser M. // Korean Journal of Anesthesiology;Aug2012, Vol. 63 Issue 2, p113 

    Background: This prospective, randomized, double blinded, controlled study was designed to compare effects of intravenous co-administration of clonidine, magnesium, or ketamine on anesthetic consumption, intraoperative hemodynamics, postoperative analgesia and recovery indices during Bispectral...

  • Genel Anestezi Uygulamasinda Gelisen Spontan Pn�motoraks. Yildiz, Emel Fikir; �rnek, Dilsen; Erk, G�lcan; Horasanli, Ey�p; Demiroglu, Melek; Kilci, Oya; Gamli, Mehmet // Journal of the Turkish Anaesthesiology & Intensive Care Society ;Jul2010, Vol. 38 Issue 4, p298 

    Pneumothorax is a lung collapse which occurs after entrance of air into pleural space. Primary spontaneous pneumothorax develops in individuals who have no clinically apparent lung disease. In this case report we presented a patient with primary spontaneous pneumothorax. The case was chronic...

  • Subcutaneous emphysema after dental procedure. Hsu, Huan-Lun; Chang, Chin-Chen; Liu, Kao-Lang // QJM: An International Journal of Medicine;Jun2011, Vol. 104 Issue 6, p545 

    No abstract available.

  • Successful anesthetic management in a child after traumatic rupture of left main bronchus by a single-lumen cuffed-endotracheal tube. Elgendy, Hamed; Jilani, Tariq // Annals of Cardiac Anaesthesia;Sep-Dec2014, Vol. 17 Issue 4, p292 

    Tracheobronchial injury (TBI) may lead to catastrophe if remains undetected or managed improperly. The incidence of TBI is less in children as compared with adults due to their pliable chest wall. Its clinical manifestations include persistent pneumothorax, cervical subcutaneous emphysema,...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics