Re-expansion pulmonary edema

Case contributed by Dr Jayanth Keshavamurthy

Presentation

Patient was intubated elsewhere and transferred to a tertiary medical center.

Patient Data

Age: 20 years
Gender: Female
X-ray

There is right main stem intubation. There is complete colapse of left lung with mediastinal shift to left. There is hyperexpansion of the right lung.

Unilateral pulmonary edema from rexpansion

X-ray

The endotracheal tube is low. There is a left pleural pigtail catheter. There is unilateral left lung re-expansion pulmonary edema.

Case Discussion

The ET tube was lower on a film 4 hours prior to the first. The left lung was collapsed due to a right mainstem intubation. It was not recognized by the team on the floor. They did retract the ET tube and also put in a chest tube which was not necessary.

Fortunately, the patient did well and went home without any complications like a broncho-pleural fistula.

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