Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.11043
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
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.
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.
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 req