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Negative pressure pulmonary edema after laparoscopic cholecystectomy: A case report and literature review
Xu Deng1, Chun-Yuan Yang, Zong-Long Zhu
1Department of Hepatobiliary and Pancreatic Surgery, the People's Hospital of Lezhi, Lezhi, China.
Rationale:
Negative pressure pulmonary edema (NPPE) is an acute onset of non-cardiogenic interstitial pulmonary edema, commonly seen among surgical patients after extubation from general aneasthesia. It is mainly caused by rapid inspiration with acute upper airway obstruction resulting in significant negative thoracic pressure.
Patient Concerns:
A 24-year-old female patient who underwent laparoscopic cholecystectomy under general anesthesia and developed NPPE postoperatively.
Diagnoses:
Her main clinical manifestation was coughing up pink foamy sputum; postoperative CT showed increased texture in both lungs and bilateral ground glass opacities.
Interventions:
Diuretics and steroids were used, and symptomatic supportive treatments such as oxygen were given.
Outcomes:
After treatment, on the fourth post-operative day, her symptoms were relieved and her vital signs were stable enough for her to be discharged.
Lessons:
Although this is a rare and severe complication, the prognosis of NPPE is good when it is managed with proper diagnosis and treatment.
