Intraoperative Tension Pneumothorax in a Child during Bronchogenic Cyst Excision – An Anesthetic Nightmare

ABSTRACT The bronchogenic cyst is a class of lung malformations that are congenital and non-vascular. Surgical excision per se is a great challenge for anesthesiologists as there have been cases with complications of fatal tension pneumothorax. Our patient is an 11-month-old child who underwent surgical excision of the bronchogenic cyst compressing the left bronchus. Intraoperatively, due to positive pressure ventilation, tension pneumothorax developed, ultimately leading to cardiac arrest. Prompt treatment with cardiopulmonary resuscitation followed by needle insertion in the second intercostal space on the right side, followed by an intercostal drain, revivedthe patient. An early diagnosis and an adequate approach to possible complications is the key to successful anesthetic management.