A Case of Contralateral Reexpansion Pulmonary Edema After Thoracoscopy Under Local Anesthesia

DOI
  • Suzuki Yoshihiro
    Department of Respiratory Medicine and Allergology, Kariya Toyota General Hospital
  • Takeda Naoya
    Department of Respiratory Medicine and Allergology, Kariya Toyota General Hospital
  • Shibata Hirofumi
    Department of Respiratory Medicine and Allergology, Kariya Toyota General Hospital
  • Oka Keisuke
    Department of Respiratory Medicine and Allergology, Kariya Toyota General Hospital
  • Kitagawa Hiroyoshi
    Department of Respiratory Medicine and Allergology, Kariya Toyota General Hospital
  • Matsui Akira
    Department of Respiratory Medicine and Allergology, Kariya Toyota General Hospital
  • Majima Suguru
    Department of Respiratory Medicine and Allergology, Kariya Toyota General Hospital
  • Miyazawa Ayako
    Department of Respiratory Medicine and Allergology, Kariya Toyota General Hospital
  • Yoshida Norio
    Department of Respiratory Medicine and Allergology, Kariya Toyota General Hospital
  • Katoh Toshiyuki
    Department of Respiratory Medicine and Allergology, Kariya Toyota General Hospital
  • Iwata Masaru
    Department of Respiratory Medicine and Allergology, Kariya Toyota General Hospital

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Other Title
  • 局所麻酔下胸腔鏡検査後に対側に発症した再膨張性肺水腫の1例

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Abstract

Background. Reexpansion pulmonary edema (RPE) is a known complication of chest drainage for pneumothorax and pleural effusion; however, few reports have documented the development of contralateral edema. Case. A 62-year-old woman visited our hospital because of dyspnea. Chest radiography showed a large left pleural effusion and mediastinal shift. Thoracoscopy and biopsy of the parietal pleura were performed under local anesthesia, along with drainage tube placement. She complained of dyspnea after returning to her hospital room. Chest radiography showed a ground-glass opacity in the right lower lung field. We diagnosed RPE and treated her with a systemic steroid and noninvasive positive pressure ventilation. Her symptoms and edema on chest radiograph had improved the next day. We assumed the complication, RPE, was caused by a rapid expansion of the right middle lobe, compressed by the heart shifting to the right. Conclusion. A pleural effusion with a mediastinal shift should be drained in advance, even with a full atelectasis, because development of an RPE in the contralateral lung is possible.

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