title: Bilateral primary spontaneous pneumothoraces postcaesarean section--another reason to avoid general anaesthesia in pregnancy.
abstract: A 36-year-old, healthy, primiparous female underwent a caesarean section under general anaesthetic. She had previously had a severe reaction to dye during a myelogram and therefore, had declined epidural analgesia or regional anaesthesia. Induction and maintenance of anaesthesia was uneventful, but on emergence, and before tracheal extubation, the patient coughed on the endotracheal tube and almost immediately developed right-sided subcutaneous emphysema of the face and neck. At this point her oxygen saturation began to fall and she was noted to be difficult to ventilate. Clinically and radiologically, she had a right-sided pneumothorax which was treated immediately with intercostal drain insertion. She went on to develop a left pneumothorax which also required intercostal drain insertion. She made an uneventful recovery and was discharged 8 days later. A subsequent CT scan of her chest revealed no pre-existing primary pulmonary pathology that would have accounted for the pneumothoraces.
authors.affiliation: Obstetrics and Gynaecology Department, Stoke Mandeville Hospital, Aylesbury, UK. christina.aye@gmail.com
authors.forename: Christina Yi Ling
authors.initials: CY
authors.lastname: Aye
authors.forename: David
authors.initials: D
authors.lastname: McKean
authors.forename: Allan
authors.initials: A
authors.lastname: Dark
authors.forename: S Adeyemi
authors.initials: SA
authors.lastname: Akinsola
mesh_terms: D000328:Adult; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D002585:Cesarean Section; D015505:Chest Tubes; D005260:Female; D006801:Humans; D011030:Pneumothorax / Q000209:etiology* / Q000628:therapy; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy; D011247:Pregnancy; D013352:Subcutaneous Emphysema / Q000209:etiology / Q000628:therapy; D014057:Tomography, X-Ray Computed