Tension pneumothorax during tracheoesophageal fistula repair: A case report

Park, Sangyoung; Lee, Haemi

doi:2015.10.2.134

Anesth Pain Med > Volume 10(2); 2015 > Article

Case Report

Pediatric Anesthesia

Anesthesia and Pain Medicine 2015;10(2):134-137.
DOI: https://doi.org/10.17085/apm.2015.10.2.134 Published online April 30, 2015.

Tension pneumothorax during tracheoesophageal fistula repair: A case report

Sangyoung Park, Haemi Lee

Department of Anesthesiology and Pain Medicine, Yeungnam University School of Medicine, Daegu, Korea. hmlee@yu.ac.kr

Received: 19 February 2014 • Revised: 12 June 2014 • Accepted: 2 October 2014

Abstract

Tension pneumothorax (PTx) was diagnosed in a preterm baby during surgery for tracheoesophageal fistula (TEF). The PTx occurred around 90 minutes after skin incision, while the baby was breathing spontaneously with intermittent positive pressure ventilation (PPV) at low pressure. A sudden decrease in oxygen saturation (SpO2), hemodynamic compromise, and decreased breath sounds on the right side suggested a right-sided tension PTx. After prompt radiological confirmation, needle aspiration of air through the surgical site restored the patient's condition immediately. Although the sudden unexpected hypoxemia and circulatory problems may confuse anesthesiologists, prompt diagnosis and proper treatment are required for successful clinical outcomes in tension PTx.

Key Words: Desaturation, Pneumothorax, Prematurity