PMID: 11927822Apr 3, 2002Paper

Bilateral pneumothoraces, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema following intubation with a double-lumen endotracheal tube for thoracoscopic anterior spinal release and fusion in a patient with idiopathic scoliosis

Journal of Spinal Disorders & Techniques
Daniel J Sucato, Magda Girgis

Abstract

Recently, thoracoscopic approaches to the spine have taken on greater clinical applications in the treatment of spinal deformity with generally good results. However, the steep learning curve must be ascended by the surgeon and may lead to complications early in one's experience. There also exists a learning curve for the anesthesiologist to become adept at obtaining single lung ventilation and managing this throughout the operative procedure. We report a case of an 11-year-old patient with severe scoliosis who developed air in both chest cavities, mediastinum, peritoneum, retroperitoneum, and subcutaneous tissue after intubation with a double-lumen endotracheal tube. The patient remained hemodynamically stable throughout this period, and bilateral chest tubes were placed. The patient remained on the ventilator for 24 hours and was extubated without sequelae. Complications from a thoracoscopic approach to the spine for deformity are most often attributed to the learning curve of the surgeon; however, the entire operative team becomes exposed to the challenges of performing this procedure. This report documents a life-threatening complication of air throughout the chest, mediastinum, abdomen, and subcutaneous tissues in a patien...Continue Reading

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Citations

Jun 27, 2003·Journal of Cardiothoracic and Vascular Anesthesia·Katherine P Grichnik, Steven E Hill
Aug 2, 2003·Journal of the American College of Surgeons·Paul M Colombani
Jan 26, 2007·The Journal of Craniofacial Surgery·Hossein HojjatiHamed Ghoddusi Johari
Jan 11, 2007·Seminars in Pediatric Surgery·Scott A Engum
Feb 15, 2005·Thoracic Surgery Clinics·Javier H Campos
Sep 24, 2009·The Orthopedic Clinics of North America·Umile Giuseppe LongoVincenzo Denaro
Dec 8, 2004·Seminars in Cardiothoracic and Vascular Anesthesia·Katherine P Grichnik, Thomas A D'Amico
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Jan 1, 2016·JBJS Case Connector·Jacob D ZieglerRafael S Andrade
Aug 2, 2003·The Journal of the American Academy of Orthopaedic Surgeons·Daniel J Sucato

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