Respiratory distress associated with acute hydrothorax during transurethral electrocoagulation: a case report.

Abstract

BACKGROUND:

In patients undergoing abdominal radiotherapy or transurethral surgery, bladder perforations are a possible complication. Likewise, pleural effusions due to a pleuroperitoneal leak caused by either a congenital or acquired diaphragmatic defect can also occur. We report a case in which a saline solution, which migrated into the abdominal cavity from a bladder perforation during transurethral electrocoagulation, further formed bilateral pleural effusions and caused rapid ventilation failure.

CASE PRESENTATION:

A patient undergoing radiation therapy and hormone therapy for prostate cancer underwent emergency surgery for electrocoagulation due to hematuria and a rapid drop in hemoglobin. The surgery began under general anesthesia, and we first noticed an increase in airway pressure and a decrease in dynamic lung compliance, followed by abdominal distension. Based on readouts from the respiratory mechanics monitor, we suspected lung abnormalities and performed a pulmonary ultrasound, leading to a diagnosis of bilateral pleural effusions, which we then drained.

CONCLUSIONS:

Respiratory mechanics monitoring is simple and can be performed at all times during anesthesia, and when combined with pulmonary ultrasound, diagnoses can be made quickly and prevent deaths.

• Authors: Mei Sunabe, Takuo Hoshi, Emina Niisato
• Journal: BMC anesthesiology (BMC Anesthesiol) Vol. 22 Issue 1 Pg. 37 (02 02 2022) ISSN: 1471-2253 [Electronic] England
• PMID: 35105305 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2022. The Author(s).

Topics

• Acute Disease
• Aged
• Drainage (methods)
• Electrocoagulation (adverse effects)
• Humans
• Hydrothorax (etiology, therapy)
• Male
• Respiratory Insufficiency (etiology, therapy)