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Pneumothorax after Shoulder Arthroscopy: A Rare but Life-threatening Complication

INTRODUCTION: Arthroscopy has become a major diagnostic tool and treatment option for shoulder pathology. However rare, respiratory complications such as a pneumothorax have been reported in patients undergoing shoulder arthroscopy. Surgery - as well as anesthesiology-related factors and respiratory...

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Autores principales: Bamps, Sven, Renson, Daan, Nijs, Stefaan, Sermon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Orthopaedic Research Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5288619/
https://www.ncbi.nlm.nih.gov/pubmed/28164043
http://dx.doi.org/10.13107/jocr.2250-0685.542
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author Bamps, Sven
Renson, Daan
Nijs, Stefaan
Sermon,
author_facet Bamps, Sven
Renson, Daan
Nijs, Stefaan
Sermon,
author_sort Bamps, Sven
collection PubMed
description INTRODUCTION: Arthroscopy has become a major diagnostic tool and treatment option for shoulder pathology. However rare, respiratory complications such as a pneumothorax have been reported in patients undergoing shoulder arthroscopy. Surgery - as well as anesthesiology-related factors and respiratory comorbidity have been hypothesized to intervene in the onset of respiratory complications. CASE REPORT: We report the case of a 42-year-old male patient who underwent an arthroscopy of the left shoulder. The anesthesia, the surgical procedure as well as the post-operative course went uncomplicated. The patients were discharged 6 h after the end of the surgical procedure. 4 h after discharge, however, the patient developed severe respiratory distress and signs of hemodynamic shock due to an ipsilateral (tension) post-operative pneumothorax. The available literature is reviewed focusing on the possible pathogenic mechanisms implying the development of this complication. CONCLUSION: The presence of a pneumothorax after shoulder arthroscopy is a rare but dangerous complication. It can primarily be attributed to rupture of parietal pleura, rupture of visceral pleura, and alveolar rupture or trauma during anesthesia. In our patient, we speculate that a rupture of parietal pleura was the underlying cause. This can be related to the surgical methodology (portal placement and continuous pump infusion with intermittent suction) and subacromial distention used during the procedure. Awareness, prompt recognition, and treatment are necessary.
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spelling pubmed-52886192017-02-03 Pneumothorax after Shoulder Arthroscopy: A Rare but Life-threatening Complication Bamps, Sven Renson, Daan Nijs, Stefaan Sermon, J Orthop Case Rep Case Report INTRODUCTION: Arthroscopy has become a major diagnostic tool and treatment option for shoulder pathology. However rare, respiratory complications such as a pneumothorax have been reported in patients undergoing shoulder arthroscopy. Surgery - as well as anesthesiology-related factors and respiratory comorbidity have been hypothesized to intervene in the onset of respiratory complications. CASE REPORT: We report the case of a 42-year-old male patient who underwent an arthroscopy of the left shoulder. The anesthesia, the surgical procedure as well as the post-operative course went uncomplicated. The patients were discharged 6 h after the end of the surgical procedure. 4 h after discharge, however, the patient developed severe respiratory distress and signs of hemodynamic shock due to an ipsilateral (tension) post-operative pneumothorax. The available literature is reviewed focusing on the possible pathogenic mechanisms implying the development of this complication. CONCLUSION: The presence of a pneumothorax after shoulder arthroscopy is a rare but dangerous complication. It can primarily be attributed to rupture of parietal pleura, rupture of visceral pleura, and alveolar rupture or trauma during anesthesia. In our patient, we speculate that a rupture of parietal pleura was the underlying cause. This can be related to the surgical methodology (portal placement and continuous pump infusion with intermittent suction) and subacromial distention used during the procedure. Awareness, prompt recognition, and treatment are necessary. Indian Orthopaedic Research Group 2016 /pmc/articles/PMC5288619/ /pubmed/28164043 http://dx.doi.org/10.13107/jocr.2250-0685.542 Text en Copyright: © Indian Orthopaedic Research Group http://creativecommons.org/licenses/by-nc-sa/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc-sa/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Bamps, Sven
Renson, Daan
Nijs, Stefaan
Sermon,
Pneumothorax after Shoulder Arthroscopy: A Rare but Life-threatening Complication
title Pneumothorax after Shoulder Arthroscopy: A Rare but Life-threatening Complication
title_full Pneumothorax after Shoulder Arthroscopy: A Rare but Life-threatening Complication
title_fullStr Pneumothorax after Shoulder Arthroscopy: A Rare but Life-threatening Complication
title_full_unstemmed Pneumothorax after Shoulder Arthroscopy: A Rare but Life-threatening Complication
title_short Pneumothorax after Shoulder Arthroscopy: A Rare but Life-threatening Complication
title_sort pneumothorax after shoulder arthroscopy: a rare but life-threatening complication
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5288619/
https://www.ncbi.nlm.nih.gov/pubmed/28164043
http://dx.doi.org/10.13107/jocr.2250-0685.542
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