Bilateral upper lobe pulmonary edema during gynecologic laparoscopic surgery in the Trendelenberg position: A case report.
10.4097/kjae.2010.59.S.S163
- Author:
Jae Hang SHIM
1
;
Woo Jong SHIN
;
Sang Hoon LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea. swj0208@hanyang.ac.kr
- Publication Type:Case Report
- Keywords:
Laparoscopic surgery;
Trendelenberg position;
Upper lobe pulmonary edema
- MeSH:
Adult;
Female;
Humans;
Laparoscopy;
Lung;
Pregnancy;
Pregnancy, Ectopic;
Pulmonary Edema;
Respiration, Artificial;
Thorax
- From:Korean Journal of Anesthesiology
2010;59(Suppl):S163-S166
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 25-year-old woman was diagnosed with a ruptured ectopic pregnancy. During laparoscopic surgery, the patient was in the Trendelenberg position (20degrees degrees). Massive froth in the endotracheal tube was observed at the end of surgery. A portable chest x-ray, checked at the end of the operation, showed diffuse haziness in both upper lung fields. After one hour of aggressive treatment with drugs and positive mechanical ventilation, the amount of froth in the endotracheal tube was reduced considerably. Considering the symptom and radiologic findings, we concluded that diffuse bilateral upper lung field haziness was due to atypical pulmonary edema. We speculated that the rapid improvement of pulmonary edema was due to redistribution of fluid to the lowest part of lung by immediate reversing the patient's Trendelenberg position, along with aggressive treatment.
