Right pneumonectomy syndrome presenting as a cardiac arrest in a two-year-old.
BACKGROUND
Pneumonectomy syndrome is a rare complication after pneumonectomy with variable onset and presentation. It is characterized by extrinsic airway compression secondary to mediastinal shift. As far as we are aware, we are reporting the first pediatric case of pneumonectomy syndrome presenting as a cardio-pulmonary arrest.


METHODS
A two-year-old boy presented with a cardiac arrest 8 months after his pneumonectomy. He failed extubation twice. A flexible bronchoscopy was then performed which revealed external compression of the left mainstem bronchus. He underwent surgical correction with a prosthetic, thoracic implant.


RESULTS
The patient's trachea was subsequently extubated to room air on postoperative day 1. He remains clinically stable at 6 month follow-up.


CONCLUSIONS
Postpneumonectomy syndrome is a rare but serious complication after pneumonectomy. If the airway compression occurs in conjunction with compromised vena caval return, cardio-pulmonary arrest can occur. Therefore, timely diagnosis and early intervention is required.
Amin
Reshma
R
Department of Pediatric Respiratory Medicine (RA), The Hospital for Sick Children, Toronto, ON, Canada. reshma.amin@sickkids.ca
Joshi
Vinay
V
Cox
Peter
P
D000402:Airway Obstruction / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D001999:Bronchoscopy / Q000379:methods; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D011013:Pneumonectomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis; D018202:Pulmonary Blastoma / Q000175:diagnosis / Q000601:surgery*; D013902:Radiography, Thoracic; D012086:Reoperation; D018570:Risk Assessment; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome