Bilateral tension pneumothorax during endoscopic submucosal dissection under general anesthesia diagnosed by point-of-care ultrasound - A case report -
Background Endoscopic submucosal dissection has become popular. However, this can cause serious complications. In this case, esophageal perforation caused bilateral tension pneumothorax. Case A 60-year-old man with esophageal adenoma underwent endoscopic submucosal dissection under general anesthesi...
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2021-04-01
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| Series: | Anesthesia and Pain Medicine |
| Subjects: | |
| Online Access: | http://www.anesth-pain-med.org/upload/pdf/apm-20088.pdf |
| _version_ | 1797825429026897920 |
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| author | Seok Kyeong Oh Seung Inn Cho Young Ju Won Jin Hee Yun |
| author_facet | Seok Kyeong Oh Seung Inn Cho Young Ju Won Jin Hee Yun |
| author_sort | Seok Kyeong Oh |
| collection | DOAJ |
| description | Background Endoscopic submucosal dissection has become popular. However, this can cause serious complications. In this case, esophageal perforation caused bilateral tension pneumothorax. Case A 60-year-old man with esophageal adenoma underwent endoscopic submucosal dissection under general anesthesia. The peak airway pressure was 25 cmH2O after induction but abruptly increased to 40 cmH2O after 30 min. Respiratory sounds were barely heard. The lack of lung sliding in either (right-dominant) lung on ultrasound. Within minutes, oxygen saturation and systolic blood pressure decreased to 52% and 70 mmHg. Emergent needle thoracostomy, followed by chest tube insertion, was performed on right chest and his vital signs stabilized. Upon transfer to intensive care unit, oxygen saturation and blood pressure decreased again; therefore, a left chest tube was inserted. Conclusions Pneumothorax due to esophageal perforation can lead to life-threatening tension pneumothorax. Anesthesiologists should be aware of the risks and emergency treatment. Ultrasound can be useful for immediate bedside patient-care decisions. |
| first_indexed | 2024-03-13T10:53:53Z |
| format | Article |
| id | doaj.art-f5466f469d4b4babb42bc10d603ad4d2 |
| institution | Directory Open Access Journal |
| issn | 1975-5171 2383-7977 |
| language | English |
| last_indexed | 2024-03-13T10:53:53Z |
| publishDate | 2021-04-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Anesthesia and Pain Medicine |
| spelling | doaj.art-f5466f469d4b4babb42bc10d603ad4d22023-05-17T05:46:36ZengKorean Society of AnesthesiologistsAnesthesia and Pain Medicine1975-51712383-79772021-04-0116217117610.17085/apm.200881070Bilateral tension pneumothorax during endoscopic submucosal dissection under general anesthesia diagnosed by point-of-care ultrasound - A case report -Seok Kyeong Oh0Seung Inn Cho1Young Ju Won2Jin Hee Yun3 Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, KoreaBackground Endoscopic submucosal dissection has become popular. However, this can cause serious complications. In this case, esophageal perforation caused bilateral tension pneumothorax. Case A 60-year-old man with esophageal adenoma underwent endoscopic submucosal dissection under general anesthesia. The peak airway pressure was 25 cmH2O after induction but abruptly increased to 40 cmH2O after 30 min. Respiratory sounds were barely heard. The lack of lung sliding in either (right-dominant) lung on ultrasound. Within minutes, oxygen saturation and systolic blood pressure decreased to 52% and 70 mmHg. Emergent needle thoracostomy, followed by chest tube insertion, was performed on right chest and his vital signs stabilized. Upon transfer to intensive care unit, oxygen saturation and blood pressure decreased again; therefore, a left chest tube was inserted. Conclusions Pneumothorax due to esophageal perforation can lead to life-threatening tension pneumothorax. Anesthesiologists should be aware of the risks and emergency treatment. Ultrasound can be useful for immediate bedside patient-care decisions.http://www.anesth-pain-med.org/upload/pdf/apm-20088.pdfdiagnostic ultrasoundendoscopic gastrointestinal surgical proceduresendoscopic mucosal resectiongeneral anesthesiatension pneumothorax |
| spellingShingle | Seok Kyeong Oh Seung Inn Cho Young Ju Won Jin Hee Yun Bilateral tension pneumothorax during endoscopic submucosal dissection under general anesthesia diagnosed by point-of-care ultrasound - A case report - Anesthesia and Pain Medicine diagnostic ultrasound endoscopic gastrointestinal surgical procedures endoscopic mucosal resection general anesthesia tension pneumothorax |
| title | Bilateral tension pneumothorax during endoscopic submucosal dissection under general anesthesia diagnosed by point-of-care ultrasound - A case report - |
| title_full | Bilateral tension pneumothorax during endoscopic submucosal dissection under general anesthesia diagnosed by point-of-care ultrasound - A case report - |
| title_fullStr | Bilateral tension pneumothorax during endoscopic submucosal dissection under general anesthesia diagnosed by point-of-care ultrasound - A case report - |
| title_full_unstemmed | Bilateral tension pneumothorax during endoscopic submucosal dissection under general anesthesia diagnosed by point-of-care ultrasound - A case report - |
| title_short | Bilateral tension pneumothorax during endoscopic submucosal dissection under general anesthesia diagnosed by point-of-care ultrasound - A case report - |
| title_sort | bilateral tension pneumothorax during endoscopic submucosal dissection under general anesthesia diagnosed by point of care ultrasound a case report |
| topic | diagnostic ultrasound endoscopic gastrointestinal surgical procedures endoscopic mucosal resection general anesthesia tension pneumothorax |
| url | http://www.anesth-pain-med.org/upload/pdf/apm-20088.pdf |
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