Postextubation negative-pressure pulmonary edema after an appendectomy

Negative pressure pulmonary edema (NPPE) is a rare, underdiagnosed, and potentially dangerous postoperative complication with the prevalence of 0.05%-0.1%. An 18-year-old healthy and athletic male developed a sensation of a lump in the throat, hemoptysis, wheezing, and acute respiratory failure, aft...

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Main Authors: Gordon S. Wong, MD, Dewayne Campbell, DO
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325002638
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author Gordon S. Wong, MD
Dewayne Campbell, DO
author_facet Gordon S. Wong, MD
Dewayne Campbell, DO
author_sort Gordon S. Wong, MD
collection DOAJ
description Negative pressure pulmonary edema (NPPE) is a rare, underdiagnosed, and potentially dangerous postoperative complication with the prevalence of 0.05%-0.1%. An 18-year-old healthy and athletic male developed a sensation of a lump in the throat, hemoptysis, wheezing, and acute respiratory failure, after an extubation following general anesthesia for an uncomplicated appendectomy. Computed tomography showed extensive bilateral pulmonary edema. He was managed with supplemental oxygen, albuterol, and diuretic. Supplemental oxygen was weaned off on hospital day 3. The hospital course was complicated by presyncope from orthostatic hypotension secondary to over-diuresis. The pathophysiology, diagnosis, management, and outcome of NPPE are illustrated and discussed in this case report. Furthermore, this case highlights that clinicians should balance the benefit of removing fluid from lungs and the risk of hypovolemia with the cautious use of diuretic.
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spelling doaj-art-b079300bb74b4ac78d0801aa6e24e6b52025-08-20T03:09:07ZengElsevierRadiology Case Reports1930-04332025-06-012063063306610.1016/j.radcr.2025.03.053Postextubation negative-pressure pulmonary edema after an appendectomyGordon S. Wong, MD0Dewayne Campbell, DO1Department of Radiology, Keck Medicine of University of Southern California, Los Angeles, CA, USA; Department of Radiology, Los Angeles General Medical Center, Los Angeles, CA, USA; Department of Internal Medicine, Yale New Haven Health, Greenwich Hospital, Greenwhich, CT, USA; Corresponding author.Department of Internal Medicine, Yale New Haven Health, Greenwich Hospital, Greenwhich, CT, USA; Department of Internal Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, USANegative pressure pulmonary edema (NPPE) is a rare, underdiagnosed, and potentially dangerous postoperative complication with the prevalence of 0.05%-0.1%. An 18-year-old healthy and athletic male developed a sensation of a lump in the throat, hemoptysis, wheezing, and acute respiratory failure, after an extubation following general anesthesia for an uncomplicated appendectomy. Computed tomography showed extensive bilateral pulmonary edema. He was managed with supplemental oxygen, albuterol, and diuretic. Supplemental oxygen was weaned off on hospital day 3. The hospital course was complicated by presyncope from orthostatic hypotension secondary to over-diuresis. The pathophysiology, diagnosis, management, and outcome of NPPE are illustrated and discussed in this case report. Furthermore, this case highlights that clinicians should balance the benefit of removing fluid from lungs and the risk of hypovolemia with the cautious use of diuretic.http://www.sciencedirect.com/science/article/pii/S1930043325002638Negative pressure pulmonary edemaGeneral anesthesiaAppendectomyComputed tomography
spellingShingle Gordon S. Wong, MD
Dewayne Campbell, DO
Postextubation negative-pressure pulmonary edema after an appendectomy
Radiology Case Reports
Negative pressure pulmonary edema
General anesthesia
Appendectomy
Computed tomography
title Postextubation negative-pressure pulmonary edema after an appendectomy
title_full Postextubation negative-pressure pulmonary edema after an appendectomy
title_fullStr Postextubation negative-pressure pulmonary edema after an appendectomy
title_full_unstemmed Postextubation negative-pressure pulmonary edema after an appendectomy
title_short Postextubation negative-pressure pulmonary edema after an appendectomy
title_sort postextubation negative pressure pulmonary edema after an appendectomy
topic Negative pressure pulmonary edema
General anesthesia
Appendectomy
Computed tomography
url http://www.sciencedirect.com/science/article/pii/S1930043325002638
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