Monday, October 8, 2012

Thought I Fixed It

A patient presents with shortness of breath and an X-ray shown above. His hemodynamics are stable. You recognize the diagnosis and heroically perform a procedure under local anesthesia to correct the pathology. You pat yourself on the back, order an X-ray, and go back to the call room.

Unfortunately, the repeat X-ray is shown below.
The patient has severe cough, dyspnea, and hypoxemia.

Challenge: What happened?

First image shown under Creative Commons Attribution Share-Alike License. Second image shown under Fair Use.


tree said...

Pulmonary edema from re-expansion

Craig Chen said...

yes, you're right!
Thought I Fixed It

This is re-expansion pulmonary edema, which can occur after re-expansion of a pneumothorax, evacuation of a large amount of pleural fluid, or removal of an obstructing endobronchial tumor.

Sources: UpToDate; Wikipedia;