Acute hypoxaemia due to intraoperative lung collapse after repositioning the patient

Desaturation after induction of anaesthesia and repositioning due to mucus plug causing atelectasis (lung collapse) is a rare event. We present a case of intraoperative right lung collapse due to mucus plug in a patient undergoing left laparoscopic nephrectomy. Hypoxaemia occurred after the induction of anaesthesia and repositioning. X-ray chest revealed right lung collapse and surgery was subsequently postponed. Lung re-expanded after postural drainage and suction. Postoperatively patient was diagnosed to have retrocardiac bronchiectasis. After preoperative preparation with postural drainage, chest physiotherapy, and antibiotics, the patient underwent surgery uneventfully.