Pneumothorax Following Breast Surgery at an Ambulatory Surgery Center

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Pulmonology

Background:

• Pneumothorax is a recognized complication of breast surgery.
• It is often underdiagnosed by anesthesiologists.
• Potential causes include needle injury, surgical trauma, and mechanical ventilation.

Observation:

• Two cases of pneumothorax occurred after bilateral mastectomy with pectoral blocks and reconstruction.
• Cases happened in an ambulatory surgery center in patients without prior lung disease.
• One patient presented with symptoms; the other was asymptomatic but diagnosed via chest X-ray.

Findings:

• Both patients required chest tube placement for treatment.
• They were hospitalized and later discharged.
• Pneumothorax can manifest as hypoxemia, shortness of breath, chest pain, or hemodynamic collapse.

Implications:

• Anesthesiologists must consider pneumothorax in the differential diagnosis for post-breast surgery patients.
• Ultrasound offers rapid diagnosis, while tension pneumothorax requires immediate needle decompression.
• Emergency equipment for pneumothorax treatment should be readily available where breast surgery is performed.