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Revista Colombiana de Cirugía
Print version ISSN 2011-7582On-line version ISSN 2619-6107
Abstract
PINO-MARIN, Antonia; REY-AYALA, Milena; MEZA-CABRERA, María del Mar and CARRILLO-BAYONA, Jorge Alberto. Pulmonary edema due to re-expansion. Case Report. rev. colomb. cir. [online]. 2024, vol.39, n.2, pp.319-325. Epub Sep 23, 2023. ISSN 2011-7582. https://doi.org/10.30944/20117582.2319.
Introduction.
Re-expansion pulmonary edema is a rare complication secondary to rapid pulmonary re-expansion after drainage by thoracentesis and/or closed thoracostomy. As of today, an incidence of less than 1% has been described after closed thoracostomy, with a higher prevalence in the second and third decades of life. Its exact pathophysiological mechanism is unknown; a multifactorial process of lung interstitial damage associated with an imbalance of hydrostatic forces has been proposed.
Clinical case.
We present the case of a patient who developed pulmonary edema due to re-expansion after closed thoracostomy, conducting a review of the literature on this complication.
Results.
Although the clinic suggests the diagnosis, the sequence of images plays a fundamental role. In most cases, it tends to be a self-limited disease, so its management is mainly supportive. However, mortality rates of up to 20% have been recorded. Therefore, it is important to identify patients with major risk factors and initiate preventive measures in these patients.
Conclusions.
Re-expansion pulmonary edema after thoracostomy is a rare complication in cases with pneumothorax; however, it is a complication that can occur in daily practice. Therefore, it must be kept in mind to be able to make the diagnosis and an adequate management.
Keywords : pulmonary edema; pneumothorax; thoracostomy; acute lung injury; iatrogenic disease; postoperative complications.