title: Development of bilateral tension pneumothorax under anesthesia in a Boerhaave's syndrome patient: a case report.
abstract: A 33-year-old male visited the emergency room with abdominal pain which developed after a vomiting episode. Based on the pneumomediastinum findings from a chest radiograph and a contrast-enhanced chest and abdominal computed tomography scan, the patient was diagnosed with Boerhaave's syndrome. Preoperative radiologic findings showed no pneumothorax or pleural effusion. Once anesthesia was administered, the patient developed near complete cardiopulmonary collapse due to a bilateral tension pneumothorax, which was treated by bilateral thoracentesis, followed by chest tube insertion. Despite a left side rupture, the damaged right lung was unable to overcome single right ventilation, so the surgery was completed via right thoracotomy. The ruptured site was treated, and the patient was transferred to the intensive care unit. We discuss the anesthetic implications of this disease and how to prevent fatal complications.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hanyang University Guri Hospital, Guri, Korea.
authors.forename: Mi Kyung
authors.initials: MK
authors.lastname: Oh
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hanyang University Guri Hospital, Guri, Korea.
authors.forename: Woo Jae
authors.initials: WJ
authors.lastname: Jeon
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hanyang University Guri Hospital, Guri, Korea.
authors.forename: Sang Yun
authors.identifier: 0000-0002-6593-1960
authors.initials: SY
authors.lastname: Cho
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hanyang University Guri Hospital, Guri, Korea.
authors.forename: Yong Deok
authors.initials: YD
authors.lastname: Kwon
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hanyang University Guri Hospital, Guri, Korea.
authors.forename: Kyoung Hun
authors.initials: KH
authors.lastname: Kim
keywords: Boerhaave syndrome; General anesthesia; Pneumothorax; Positive-pressure respiration