Re-expansion pulmonary edema

Case contributed by Jayanth Keshavamurthy
Diagnosis certain

Presentation

The patient was intubated elsewhere and transferred to a tertiary medical center.

Patient Data

Age: 20 years
Gender: Female
x-ray

There is right main bronchus intubation resulting in hyper expansion of the right lung and complete collapse of the left lung with mediastinal shift to the left.

Unilateral pulmonary edema

x-ray

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

Case Discussion

The ET tube was deep in a film 4 hours prior to the first. The left lung collapsed due to a right main bronchus intubation which 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 (i.e. broncho-pleural fistula).

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