Journal of Anesthesia and Surgery
Tension Pneumothorax during Liver and Kidney Transplantation in a Patient with Adult Polycystic Kidney Disease
Department of Anesthesiology, University of Miami, Jackson Health System, Miami, Florida, USA
Fouad G. Souki, University of Miami/Jackson Health System, 1611 NW 12th Ave, DTC 318, Miami, FL 33136, Tel: 305-585-7435, Fax: 305-585-7477, E-mail: Fsouki@miami.edu
Souki, F.G., Nasrallah, G.Tension Pneumothorax during Liver and Kidney Transplantation in a Patient with Adult Polycystic Kidney Disease. (2017) J Anesth Surg 4(1): 47- 50.
Â© 2017 Souki, F.G. This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License.
KeywordsAdult polycystic kidney disease; Tension pneumothorax; Liver transplantation; Kidney transplantation; Anesthesia
Administering anesthesia to patients undergoing liver transplantation often yields intraoperative hemodynamic instability. During this type of major surgery, many factors may contribute to hemodynamic collapse, including myocardial infarction, pulmonary embolus, bleeding, and preload reduction owing to inferior vena cava clamping. Pneumothorax, a potentially dangerous condition, can arise unexpectedly during anesthesia. Diagnosis is based on exclusion, as the initial vital sign changes, including cardiorespiratory decompensation, are non-specific. Here, we describe the case of a patient with adult polycystic kidney disease who developed intraoperative cardiovascular collapse and hypoxemia owing to tension pneumothorax during liver and kidney transplantation. We highlight the etiology of intraoperative tension pneumothorax, the sequence of hemodynamic changes, and the importance of early diagnosis and treatment.