title: Bilateral tension pneumothorax and tension pneumoperitoneum secondary to tracheal tear in a patient with relapsing polychondritis.
abstract: Relapsing polychondritis (RP) is a rare disease that is characterized by recurrent inflammation and destruction of cartilage and connective tissues. RP can have significant airway pathology that may require procedures to maintain airway patency and thus may have serious implications for anesthesiologists. Anesthesiologists must be prepared to deal with the possible complications that may occur during airway manipulation in patients with RP. Here, we present a case of life-threatening bilateral tension pneumothorax and tension pneumoperitoneum that developed after a tracheal tear during Montgomery T-tube insertion in a patient with tracheal stenosis due to RP. Correct diagnosis was delayed due to a misdiagnosis of airway obstruction. As a result, we emphasize that bilateral tension pneumothorax should be considered during refractory cardiac arrest in patients with increased airway pressure. A high index of suspicion and adequate management are mandatory for patients to survive these life-threatening complications.
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Lin
authors.forename: Zhiyi
authors.initials: Z
authors.lastname: Zuo
authors.forename: Po-Han
authors.initials: PH
authors.lastname: Lo
authors.forename: Shu-Shya
authors.initials: SS
authors.lastname: Hseu
authors.forename: Wen-Kuei
authors.initials: WK
authors.lastname: Chang
authors.forename: Kwok-Han
authors.initials: KH
authors.lastname: Chan
authors.forename: Hui-Bih
authors.initials: HB
authors.lastname: Yuan
mesh_terms: D000328:Adult; D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D008297:Male; D011027:Pneumoperitoneum / Q000209:etiology*; D011030:Pneumothorax / Q000209:etiology*; D011081:Polychondritis, Relapsing / Q000150:complications*; D014132:Trachea / Q000293:injuries*