Zhang G, Huang XY, Zhang L. Ultrasound guiding the rapid diagnosis and treatment of perioperative pneumothorax: A case report. World J Clin Cases 2021; 9(35): 11043-11049 [PMID: 35047616 DOI: 10.12998/wjcc.v9.i35.11043]
Corresponding Author of This Article
Lan Zhang, MD, Director, Doctor, Department of Anesthesia, Sichuan Provincial Orthopedic Hospital (Chengdu Sports Hospital and Chengdu Research Institute for Sports Injury), No. 132 West Section 1, First-Ring Road, Wuhou District, Chengdu 610041, Sichuan Province, China. mzzhanggang@hotmail.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 16, 2021; 9(35): 11043-11049 Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.11043
Ultrasound guiding the rapid diagnosis and treatment of perioperative pneumothorax: A case report
Gang Zhang, Xiao-Yan Huang, Lan Zhang
Gang Zhang, Lan Zhang, Department of Anesthesia, Sichuan Provincial Orthopedic Hospital (Chengdu Sports Hospital and Chengdu Research Institute for Sports Injury), Chengdu 610041, Sichuan Province, China
Xiao-Yan Huang, Department of Operation Room, the Third People's Hospital of Chengdu, Chengdu 610041, Sichuan Province, China
Author contributions: Zhang G conceived the clinical concept described; Zhang G and Huang XY contributed to the clinical conduct of the study, data collection, and writing of the manuscript; Zhang Lan contributed to analysis and interpretation of the collected data, writing, preparation of accompanying figures and material, and revision of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lan Zhang, MD, Director, Doctor, Department of Anesthesia, Sichuan Provincial Orthopedic Hospital (Chengdu Sports Hospital and Chengdu Research Institute for Sports Injury), No. 132 West Section 1, First-Ring Road, Wuhou District, Chengdu 610041, Sichuan Province, China. mzzhanggang@hotmail.com
Received: June 9, 2021 Peer-review started: June 9, 2021 First decision: July 16, 2021 Revised: July 27, 2021 Accepted: September 15, 2021 Article in press: September 15, 2021 Published online: December 16, 2021 Processing time: 184 Days and 0.5 Hours
Abstract
BACKGROUND
Pneumothorax is one of the most common causes of acute dyspnea. In patients under general anesthesia, the symptoms may not be obvious, which may delay diagnosis and treatment. Computed tomography is the gold standard for the diagnosis of pneumothorax, but is not suitable for rapid diagnosis of this complication. In contrast, lung ultrasonography can provide rapid diagnosis and treatment of pneumothorax.
CASE SUMMARY
The patient was a 53-year-old man admitted for rupture of the spleen caused by an accidental fall and emergency splenectomy was planned. Anesthesia was induced, and tracheal intubation was performed successfully with a video laryngoscope. About 2 min after tracheal intubation, the airway peak pressure increased to 50 cm H2O and the oxygen saturation dropped to 70%. According to the BLUE protocol, a recommended area of the chest was scanned by ultrasound. The pleural slide sign disappeared and obvious parallel line sign could be seen in the left lung. The boundary of pneumothorax (lung points) were rapidly confirmed by ultrasound. To avoid lung injury, a closed thoracic drainage tube was placed in the involved area. On day 9 after surgery, the patient was discharged from the hospital without any complications.
CONCLUSION
Perioperative pneumothorax is rare but dangerous. It can be rapidly diagnosed and treated with ultrasound guidance.
Core Tip: Perioperative pneumothorax is a rare but dangerous complication that requires rapid diagnosis and urgent treatment. Computed tomography is the gold standard for diagnosis pneumothorax but it is not applicable to confirm this complication during surgery. Lung ultrasonography, with the advantages of being radiation-free and convenient, can provide rapid diagnosis and treatment of pneumothorax.
