Pneumothorax during shoulder surgery.

IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL
Tidsskrift for Den Norske Laegeforening Pub Date : 2024-04-04 Print Date: 2024-04-23 DOI:10.4045/tidsskr.23.0542
Ellisiv Seines, Mariann Harneshaug, Trine Skjeflo, Fredrik Isachsen, Erik Waage Nielsen
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引用次数: 0

Abstract

Background: Pneumothorax following shoulder arthroscopy, although rare, is documented in over 30 PubMed case reports as occurring during or within 10 hours post-procedure.

Case presentation: A fit septuagenarian underwent a two-hour arthroscopic rotator cuff repair with IV anaesthesia and laryngeal mask airway, without a nerve block. With one hour remaining of the operation, the patient had desaturation and hypotension. Lung sliding was absent on ultrasound and x-ray confirmed left-sided tension pneumothorax. Successful thoracic drain insertion and lung re-expansion facilitated his recovery, allowing discharge after 24 hours and symptom-free status at 6 months.

Interpretation: This case highlights pneumothorax as an uncommon yet possible post-arthroscopic event. The speculated aetiology is the surgical procedure, where pump-induced pressure fluctuations may displace air into surrounding tissue. Instances of pneumomediastinum and subcutaneous emphysema without pneumothorax suggest arthroscopic origin of air. Prompt perioperative ultrasound can aid in detecting such critical complications.

肩部手术中的气胸。
背景:在 30 多篇 PubMed 病例报告中,肩关节镜手术后发生气胸的情况虽然罕见,但都发生在手术过程中或术后 10 小时内:一位身体健康的七旬老人接受了两小时的关节镜肩袖修复术,术中使用了静脉麻醉和喉罩气道,但未进行神经阻滞。手术还剩一个小时时,患者出现了血氧饱和度下降和低血压。超声波检查显示肺部无滑动,X光检查证实左侧张力性气胸。成功插入胸腔引流管和肺部再扩张促进了患者的康复,24 小时后患者出院,6 个月后无症状:本病例强调气胸是关节镜手术后可能发生的一种不常见的并发症。推测病因是手术过程中,泵引起的压力波动可能会将空气排入周围组织。无气胸的气胸和皮下气肿病例表明空气来自关节镜。及时进行围手术期超声检查有助于发现此类严重并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Tidsskrift for Den Norske Laegeforening
Tidsskrift for Den Norske Laegeforening MEDICINE, GENERAL & INTERNAL-
CiteScore
0.60
自引率
18.20%
发文量
593
审稿时长
28 weeks
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