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KMID : 0356919950290030447
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Korean Journal of Anesthesiology
1995 Volume.29 No. 3 p.447 ~ p.451
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Pneumothorax and Pneumoperitoneum due to Occlusion of the Scavenging System during General Endotracheal Anesthesia with Drager Anesthesia Machine
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Abstract
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Pulmonary barotrauma is defined as an extra-alveolar gas from lung damage secondary to changes in intrathoracic pressure. Pneumothorax, pneumoperitoneum, pneumomediastinum and subcutaneous emphysema developed due to complete occlusion of the
expiratory
tube of the expiratory tube of the scavenging system. During controlled endotracheal ventilation of the lungs of a 22 year old woman undergoing thyroidectomy increased airway pressure about 50 mbar on the airway pressure gauge approximately 8
minutes
after starting ventilator was detected. Vital signs were stable. Subcutaneous emphysema around the neck, face and both shoulders were observed. The expiratory tubing was found to be trapped and competely obstructed between the upper and lower
parts
of
the ventilator. The operation was cancelled and chest x-ray was taken in the operating room, which showed about 15% pneumothorax on the right chest, subcutaneous emphysema and pneumomediastinum. The follow up chest x-ray was in postanesthesia
care
unit
and pneumoperitoneum was also detected on the right upper side of the abdomen. The signs of rupture of the abdominal viscus were not noted. She recovered uneventfully with insufflation of 100% oxygen and discharged 3 days later with complete
spontaneous
resorption of the pneumothorax. (Korean J Anesthesiol 1995; 29: 447∼451)
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