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.
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2 comments:

  1. treeOctober 8, 2012 at 9:48 AM

    Pulmonary edema from re-expansion

    ReplyDelete
  2. CraigOctober 21, 2012 at 11:57 PM

    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; urmc.rochester.edu.

    ReplyDelete

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