oa Southern African Journal of Anaesthesia and Analgesia - Re-expansion pulmonary oedema after evacuation of iatrogenic tension pneumothorax : a case report
A 20- year male, ASA physical status grade I, was operated on for a duodenal fistula. The intra- and postoperative periods were uneventful. 10 days later, the right internal jugular catheter was substituted with a triple lumen catheter in the right subclavian vein. Immediate chest X- ray revealed a right haemothorax. A chest drain was inserted immediately which was removed after the complete expansion of the lung. 24 hours later, the patient's general condition deteriorated, and he was clinically diagnosed to have a right-sided tension pneumothorax. A 'gush of air' after insertion of the chest drain confirmed the presence of a pneumothorax. After a few hours, the patient developed features of pulmonary oedema, and a diagnosis of re-expansion pulmonary oedema was made. The patient's general condition deteriorated rapidly, and he did not survive. The possible causes for his demise, and a review of the literature are both discussed.
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