Bilateral tension pneumothorax during colonoscopy in a patient with chronic obstructive pulmonary disease: a case report

J Clin Anesth. 2016 Nov:34:432-5. doi: 10.1016/j.jclinane.2016.05.030. Epub 2016 Jun 16.

Abstract

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.

Keywords: Bilateral tension pneumothorax; Chronic obstructive pulmonary disease; Colonoscopy; Pain control.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Cardiopulmonary Resuscitation
  • Colon, Sigmoid / diagnostic imaging
  • Colonoscopy / adverse effects*
  • Colonoscopy / methods
  • Conscious Sedation*
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Injections, Intramuscular
  • Intestinal Volvulus / diagnosis
  • Intestinal Volvulus / diagnostic imaging
  • Male
  • Meperidine / administration & dosage
  • Midazolam / administration & dosage
  • Pneumothorax / complications
  • Pneumothorax / etiology*
  • Pneumothorax / surgery
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Radiography, Abdominal
  • Thoracentesis

Substances

  • Hypnotics and Sedatives
  • Meperidine
  • Midazolam