Development of bilateral tension pneumothorax under anesthesia in a Boerhaave's syndrome patient: a case report.
10.4097/kjae.2016.69.2.175
- Author:
Mi Kyung OH
1
;
Woo Jae JEON
;
Sang Yun CHO
;
Yong Deok KWON
;
Kyoung Hun KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Hanyang University Guri Hospital, Guri, Korea. chosy@hanyang.ac.kr
- Publication Type:Case Report
- Keywords:
Boerhaave syndrome;
General anesthesia;
Positive-pressure respiration;
Pneumothorax
- MeSH:
Abdominal Pain;
Adult;
Anesthesia*;
Anesthesia, General;
Chest Tubes;
Emergency Service, Hospital;
Humans;
Intensive Care Units;
Lung;
Male;
Mediastinal Emphysema;
Pleural Effusion;
Pneumothorax*;
Positive-Pressure Respiration;
Radiography, Thoracic;
Rupture;
Thoracotomy;
Thorax;
Ventilation;
Vomiting
- From:Korean Journal of Anesthesiology
2016;69(2):175-180
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 33-year-old male visited the emergency room with abdominal pain which developed after a vomiting episode. Based on the pneumomediastinum findings from a chest radiograph and a contrast-enhanced chest and abdominal computed tomography scan, the patient was diagnosed with Boerhaave's syndrome. Preoperative radiologic findings showed no pneumothorax or pleural effusion. Once anesthesia was administered, the patient developed near complete cardiopulmonary collapse due to a bilateral tension pneumothorax, which was treated by bilateral thoracentesis, followed by chest tube insertion. Despite a left side rupture, the damaged right lung was unable to overcome single right ventilation, so the surgery was completed via right thoracotomy. The ruptured site was treated, and the patient was transferred to the intensive care unit. We discuss the anesthetic implications of this disease and how to prevent fatal complications.
