Bilateral tension pneumothorax during colonoscopy in a patient with chronic obstructive pulmonary disease: a case report.
Colonoscopy is widely performed for the diagnosis and treatment of various colonic disorders and the screening and surveillance of colorectal neoplasia. According to research evidence, up to one-third of patients had at least 1 minor and transient gastrointestinal symptom after colonoscopy. Although severe complications developed uncommonly, they are potentially serious and life threatening. Here, we present the case of a 95-year-old man with chronic obstructive pulmonary disease who developed bilateral tension pneumothorax during therapeutic colonoscopy for sigmoid volvulus. In this case, air trapping resulting from the Valsalva maneuver under inadequate pain control may be the mechanism for fatal tension pneumothorax during colonoscopy.
Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC.
Wei-Cheng
WC
Tseng
Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC.
Chun-Chang
CC
Yeh
Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC.
Shu-Wen
SW
Jao
Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC.
Zhi-Fu
ZF
Wu
Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC. Electronic address: longer.lin@gmail.com.
Shinn-Long
SL
Lin
D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D012809:Colon, Sigmoid / Q000000981:diagnostic imaging; D003113:Colonoscopy / Q000009:adverse effects* / Q000379:methods; D016292:Procedural Sedation; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007273:Injections, Intramuscular; D045822:Intestinal Volvulus / Q000175:diagnosis / Q000000981:diagnostic imaging; D008297:Male; D008614:Meperidine / Q000008:administration & dosage; D008874:Midazolam / Q000008:administration & dosage; D011030:Pneumothorax / Q000150:complications / Q000209:etiology* / Q000601:surgery; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D011860:Radiography, Abdominal; D000069258:Thoracentesis
D006993:Hypnotics and Sedatives; D008614:Meperidine; D008874:Midazolam
Bilateral tension pneumothorax; Chronic obstructive pulmonary disease; Colonoscopy; Pain control