Negative pressure pulmonary oedema

Case contributed by Dr Jayanth Keshavamurthy

Presentation

"Possible neg pressure pulmonary edema" was on the requisition.

Patient Data

Age: 25
Gender: Male

Name a complication after extubation seen here.

Modality: X-ray

Normal heart size. Interstitial and perihilar butterfly pattern alveolar pulmonary edema.

No pleural effusion. Normal vascular pedicle.

24 hours after treatment

Modality: X-ray

Interval complete response to treatment with Furosemide.  

Case Discussion

25 year old Male who was stabbed in the forearm with a knife one month ago. Patient could not extend wrist after the injury. Radial nerve injury suspected and patient was operated for exploration and repair of radial nerve.

General endotracheal anesthesia achieved without complications

Intravenous Fluid
Albumin 5%: 500 mL.
Crystalloid: 2,700 mL.

Chart was reviewed. Patient received IV Lasix 20 mg chest even before the first chest radiograph was obtained.

Chest x-ray findings consistent with known provided history of negative pressure pulmonary edema.

This chest radio graphwas ordered by anesthesia resident who knew the mechanism of pulmonary edema here and did not bother to tell us anything else. 

A radiologist now needs to know this and then need to look into the chart to get such a history of endotracheal intubation.
 

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Case Information

rID: 35076
Case created: 20th Mar 2015
Last edited: 26th Apr 2017
System: Chest
Tags: gru chest, cxr
Inclusion in quiz mode: Included

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