title: Reexpansion pulmonary edema following local anesthetic thoracoscopy: correlation and evolution of radiographic and ultrasonographic findings.
abstract: Local anesthetic (medical) thoracoscopy is used with increasing frequency by pulmonologists worldwide for both diagnostic and therapeutic purposes, notably in comorbid patients who may not be physiologically robust enough for general anesthesia. Understanding the complications that can arise and how to manage them is crucial for any physician performing this procedure. Reexpansion pulmonary edema is a rare but recognized complication of draining pleural effusions and pneumothoraces that has not been described previously in association with physician-led thoracoscopy. This case provides an opportunity for an overview of what is known about this unusual but potentially fatal condition. Data correlating ultrasonographic, radiographic, and clinical progression are also presented to highlight the potential usefulness of ultrasonography in identifying lung parenchymal abnormalities such as extravascular lung water.
authors.affiliation: Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, England. Electronic address: jpcorcoran@doctors.org.uk.
authors.forename: John P
authors.initials: JP
authors.lastname: Corcoran
authors.affiliation: Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, England.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Psallidas
authors.affiliation: Department of Critical Care, Oxford University Hospitals NHS Trust, Oxford, England.
authors.forename: Graham
authors.initials: G
authors.lastname: Barker
authors.affiliation: Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, England.
authors.forename: Anny
authors.initials: A
authors.lastname: Sykes
authors.affiliation: Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, England.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Hallifax
authors.affiliation: Department of Radiology, Oxford University Hospitals NHS Trust, Oxford, England.
authors.forename: Fergus V
authors.initials: FV
authors.lastname: Gleeson
authors.affiliation: Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, England.
authors.forename: Najib M
authors.initials: NM
authors.lastname: Rahman
mesh_terms: D000772:Anesthesia, Local / Q000009:adverse effects* / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D004322:Drainage / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000601:surgery*; D011654:Pulmonary Edema / Q000175:diagnosis* / Q000209:etiology; D013902:Radiography, Thoracic / Q000379:methods*; D012008:Recurrence; D013906:Thoracoscopy / Q000009:adverse effects*; D014463:Ultrasonography
chemical_list: D000779:Anesthetics, Local