Korean J Anesthesiol.  2016 Apr;69(2):175-180. 10.4097/kjae.2016.69.2.175.

Development of bilateral tension pneumothorax under anesthesia in a Boerhaave's syndrome patient: a case report

• Oh MK
• Jeon WJ
• Cho SY
• Kwon YD
• Kim KH

• KMID: 2242957
• DOI: http://doi.org/10.4097/kjae.2016.69.2.175

Abstract

A 33-year-old male visited the emergency room with abdominal pain which developed after a vomiting episode. Based on the pneumomediastinum findings from a chest radiograph and a contrast-enhanced chest and abdominal computed tomography scan, the patient was diagnosed with Boerhaave's syndrome. Preoperative radiologic findings showed no pneumothorax or pleural effusion. Once anesthesia was administered, the patient developed near complete cardiopulmonary collapse due to a bilateral tension pneumothorax, which was treated by bilateral thoracentesis, followed by chest tube insertion. Despite a left side rupture, the damaged right lung was unable to overcome single right ventilation, so the surgery was completed via right thoracotomy. The ruptured site was treated, and the patient was transferred to the intensive care unit. We discuss the anesthetic implications of this disease and how to prevent fatal complications.

Keyword

Boerhaave syndrome; General anesthesia; Positive-pressure respiration; Pneumothorax

MeSH Terms

Abdominal Pain
Adult
Anesthesia*
Anesthesia, General
Chest Tubes
Emergency Service, Hospital
Humans
Intensive Care Units
Lung
Male
Mediastinal Emphysema
Pleural Effusion
Pneumothorax*
Positive-Pressure Respiration
Radiography, Thoracic
Rupture
Thoracotomy
Thorax
Ventilation
Vomiting