A Rare Complication of Cardiopulmonary Resuscitation: Tension Pneumothorax

ABSTRACT Background Tonsillectomy is one of the most common surgical procedures performed worldwide. However, it can potentially be associated with several complications. One of the very rare complications post-tonsillectomy in adults is subcutaneous emphysema, as in our case here. Although, most reported cases are resolved spontaneously, it may lead to fatal complications, like tension pneumothorax. Case report Tonsillectomy was performed on an adult patient with history of frequent tonsillitis. The patient developed facial subcutaneous emphysema 48 hours after the surgery (evident by clinical and radiological examination) that resolved within 2 days without further complications. Conclusion Tonsil should be removed along with tonsilar capsule. If tonsillectomy causes deeper than usual mucosal tear up to the level of the muscles, then air might pass into the subcutaneous tissue through the tonsillar fossa and superior constrictor muscle into fascial layers of neck. Emphysema can then spread to parapharyngeal, retropharyngeal spaces and mediastinum with its related morbidity. Though a rare complication, all otorhinolaryngologists must be aware of this complication and its management. How to cite this article Abraham SS, Stephen V, Deve L, Kurien M. Subcutaneous Emphysema Secondary to Tonsillectomy. Int J Otorhinolaryngol Clin 2015;7(2):78-80.

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Gastric perforation following improper cardiopulmonary resuscitation in out-of-hospital cardiac arrest

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.2.1363 ◽

2019 ◽

Vol 36 (2) ◽

Author(s):

Guang-Ju Zhou ◽

Pin Jin ◽

Shou-Yin Jiang

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Gastric Perforation ◽

Rare Complication ◽

Emergency Laparotomy ◽

Emergency Medical Service Personnel ◽

Mortality And Morbidity ◽

The Public ◽

Creative Commons ◽

Hospital Cardiac Arrest

Gastric perforation is a rare complication of cardiopulmonary resuscitation (CPR), mostly resulting from incorrect airway management. If left unrecognized, it is associated with high mortality and morbidity. We present a case of gastric perforation after improper CPR. A 56-year-old drunken male was sent to the emergency department due to coma after fall onto the ground. He was thought to have cardiac arrest at scene and was saved with CPR maneuver by his friends who has never been trained before. He was taken to the hospital by emergency medical service personnel and presented with abdominal distention and extensive pneumoperitoneum. Emergency laparotomy was performed which revealed gastric perforation at the lesser curvature of the stomach. The laceration was repaired without any difficulty and the patient was discharged home without any neurological deficit. The aim of this report is to remind the public and emergency physicians that gastric perforation should be suspected in patients with distended abdomen and pneumoperitoneum after CPR. Because the most common risk factor for CPR-related gastric perforation is the bystander-provided resuscitation, it is encouraged for the public to take formal CPR training. doi: https://doi.org/10.12669/pjms.36.2.1363 How to cite this:Zhou GJ, Jin P, Jiang SY. Gastric perforation following improper cardiopulmonary resuscitation in out-of-hospital cardiac arrest. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1363 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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A Rare Complication of Noncompliance Status Post-Transhiatal Esophagectomy and Esophago-Gastroanastomosis

Case Reports in Gastrointestinal Medicine ◽

10.1155/2020/8833110 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Daniel Ramirez ◽

Graham Appelbe ◽

Venkatramana Vattipally ◽

Justin Miller

Keyword(s):

Rare Complication ◽

Fistulous Tract ◽

Tension Pneumothorax ◽

Transhiatal Esophagectomy ◽

Gastric Ulcers ◽

Peptic Ulcers ◽

Orogastric Tube ◽

Presenting Symptoms ◽

Tube Output ◽

Gastropleural Fistula

Gastropleural fistulas are a complication of peptic ulcers in hiatal hernias, trauma, infections, surgical complications, and malignancy. Presenting symptoms may include gastric and chest pain with respiratory failure in the setting of pneumonitis, hydropneumothorax, or tension pneumothorax. We describe a 57-year-old male with a history of transhiatal esophagectomy and esophago-gastroanastomosis who presented in the setting of dyspnea and dark orogastric tube output. Upper endoscopy revealed multiple gastric ulcers with a dominant ulceration communicating with an adjacent space, and a fistulous tract was demonstrated on computed tomography chest, confirming a gastropleural fistula, a rare life-threatening condition.

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Cardiac rupture by penetration of fractured sternum: a rare complication of cardiopulmonary resuscitation

Resuscitation ◽

10.1016/s0300-9572(99)00137-9 ◽

2000 ◽

Vol 43 (2) ◽

pp. 151-153 ◽

Cited By ~ 36

Author(s):

M Machii ◽

H Inaba ◽

H Nakae ◽

I Suzuki ◽

H Tanaka

Keyword(s):

Cardiopulmonary Resuscitation ◽

Rare Complication ◽

Cardiac Rupture

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A Rare Complication of Boerhaave's Syndrome: Tension Pneumothorax

Hong Kong Journal of Emergency Medicine ◽

10.1177/102490791302000409 ◽

2013 ◽

Vol 20 (4) ◽

pp. 245-247 ◽

Cited By ~ 1

Author(s):

O Duman Atilla ◽

M Sever ◽

T Dogan ◽

T Uslu

Keyword(s):

Rare Complication ◽

Tension Pneumothorax ◽

Boerhaave’S Syndrome ◽

Boerhaave's Syndrome

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A Rare Complication Caused by Dry Needling Method: Tension Pneumothorax

Respiratory Case Reports ◽

10.5505/respircase.2017.58826 ◽

2017 ◽

Vol 6 (3) ◽

pp. 145-148 ◽

Cited By ~ 1

Author(s):

Nalan Kozacı ◽

Nilay Çavuşoğlu Yalçın ◽

Muharrem Özkaya ◽

Vedat Kırpat ◽

Ahmet Çelik

Keyword(s):

Rare Complication ◽

Tension Pneumothorax ◽

Dry Needling ◽

Needling Method

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Cardiopulmonary Resuscitation for Tension Pneumothorax during General Anesthesia: A Case Report

Korean Journal of Anesthesiology ◽

10.4097/kjae.1980.13.1.66 ◽

1980 ◽

Vol 13 (1) ◽

pp. 66

Author(s):

Koon Sung Song ◽

Jun Ho Kim ◽

Byung Yon Kwon

Keyword(s):

Case Report ◽

Cardiopulmonary Resuscitation ◽

General Anesthesia ◽

Tension Pneumothorax

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Tear of long head of biceps following cardiopulmonary resuscitation: a rare complication

BMJ Case Reports ◽

10.1136/bcr-2019-229218 ◽

2019 ◽

Vol 12 (5) ◽

pp. e229218

Author(s):

Deepanjan Bhattacharya ◽

Pratap Patra ◽

Rakesh Kumar Pilania ◽

Ankur Kumar Jindal

Keyword(s):

Cardiopulmonary Resuscitation ◽

Biceps Brachii ◽

Glenohumeral Joint ◽

Rare Complication ◽

Senior Resident ◽

Left Shoulder ◽

Routine Practice ◽

Unusual Complication ◽

Long Head Of Biceps ◽

Long Head

Cardiopulmonary resuscitation (CPR) is uncommon in routine practice of a paediatrician and injuries arising out of CPR are extremely rare especially in those involving children. A 41-year-old senior resident of paediatrics performed CPR on a young boy, following which he complained of pain in the left shoulder with restriction of all movements and flexion of the left elbow. MRI of the left shoulder revealed tear of the long head of biceps brachii, soft tissue oedema in left deltoid muscle and mild effusion in left glenohumeral joint with extension into subcapsularis bursa. He was treated conservatively with analgesics, following which there was significant improvement and full recovery of shoulder movements. Injuries to the resuscitator have been rarely reported in literature and mostly limited to adult CPR. We report this case to highlight an unusual complication to resuscitator transpiring from paediatric resuscitation.

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