Autopsy Findings in a Patient with Post-Obstructive Pulmonary Edema

Authors

DOI:

https://doi.org/10.21141/PJP.2019.07

Keywords:

sleep apnea, obstructive, pulmonary edema, autopsy

Abstract

Post-obstructive pulmonary edema (POPE), a form of non-cardiogenic pulmonary edema, is a significant entity in anesthesiology and head/neck surgery. This rapidly developing and life-threatening condition occurs following the relief of the obstruction in the upper airways. This condition has two main categories with distinct etiology. We report the case of a 62-year-old Filipino female who developed POPE after the removal of the endotracheal tube following a routine biopsy of her maxillary mass. Immediately after the removal of the endotracheal tube, she presented with episodes of hypotension and desaturation. Chest x-ray post-re-intubation revealed bilateral lung opacities. The autopsy findings of the respiratory and cardiovascular system are presented.  

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Author Biographies

Marissa Krizelda Santos, St. Luke’s Medical Center, Quezon City, Philippines

Institute of Pathology

Ann Margaret Chang, St. Luke's Medical Center, Quezon City, Philippines

Pathology Consultant, Institute of Pathology

Jimmy Chang, St. Luke’s Medical Center, Quezon City, Philippines

Comprehensive Sleep Disorder Center

References

1. Mehta KK, Ahmad SQ, Shah V, Lee H. Postobstructive pulmonary edema after biopsy of a nasopharyngeal mass. Respir Med Case Rep. 2015; 16:166-8.

2. Herrick IA, Mahendran B, Penny FJ. Postobstructive pulmonary edema following anesthesia. J Clin Anesth. 1990;2(2):116-20. https://pubmed.ncbi.nlm.nih.gov/2189449.

3. Tanindi A, Cemri M. Troponin elevation in conditions other than acute coronary syndromes. Vasc Health Risk Manag. 2011;597-603. https://pubmed.ncbi.nlm.nih.gov/22102783. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3212425. https://doi.org/10.2147/VHRM.S24509.

4. Butt Y, Kurdowska A, Allen TC. Acute lung injury: a clinical and molecular review. Arch Pathol Lab Med. 2016;140(4):345-50. https://pubmed.ncbi.nlm.nih.gov/27028393. https://doi.org/10.5858/arpa.2015-0519-RA.

5. Geovanini GR, Wang R, Weng J, et al. Elevations in neutrophils with obstructive sleep apnea: the multi-ethnic study of atherosclerosis (MESA). 2018;257:318-23. https://pubmed.ncbi.nlm.nih.gov/29506719. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842816 [Available on 2019-04-15]. https://doi.org/10.1016/j.ijcard.2017.10.121.

6. Ahsayan K, Ghalem A, Ouafi NE, Housni B. Post obstructive pulmonary edema: a rare and preventable etiology of postoperative respiratory distress. J Cardiol Cardiovasc Ther. 2017;6(5):555696. https://doi.org/10.19080/JOCCT.2017.06.555696.

7. Granados-Romero J, Valderrama-Treviño AI, Arauz-Peña G, et al. Acute pulmonary non-cardiogenic edema after extubation with laryngospasm: a case report. Int J Res Med Sci. 2018; 6(7):2528-32. https://doi.org/10.18203/2320-6012.ijr,s20182850.

8. Lemyze M, Mallat J. Understanding negative pressure pulmonary edema. Intensive Care Med. 2014;40(8):1140-3. https://pubmed.ncbi.nlm.nih.gov/24797685. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4148265. https://doi.org/10.1007/s00134-014-3307-7.

9. Burke AJ, Duke SG, Clyne S, Khoury SA, Chiles C, Mathews BL. Incidence of pulmonary edema after tracheotomy for obstructive sleep apnea. Otolaryngol Head Neck Surg. 2001;125(4):319-23. https://pubmed.ncbi.nlm.nih.gov/11593165. https://doi.org/10.1067/mhn.2001.117713.

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Published

2019-03-24

How to Cite

Santos, M. K., Chang, A. M., & Chang, J. (2019). Autopsy Findings in a Patient with Post-Obstructive Pulmonary Edema. PJP, 4(1), 37–42. https://doi.org/10.21141/PJP.2019.07

Issue

Section

Autopsy Vault