PMC7166272_01
Preoperative chest radiograph for the patient showing normal lung fields with mild increase in bronchocovascular markings on the right lung.
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Chest X-ray was normal except for mild increase in the basal bronchovascular markings on the right lung (Figure 1).
Airway exchange catheter (AEC) used to change the endotracheal tube (ETT).
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It was presumed that there was a leak from the tube cuff, so the endotracheal tube was exchanged using an airway exchange catheter (AEC) (Figure 2), and the tube was fixed at the 22 cm mark.
Intraoperative chest radiograph showing right-sided pneumothorax.
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The intraoperative X-ray machine (The C-arm) was requested immediately to the operating room and the chest image confirmed the presence of right-sided pneumothorax (Figure 3).
Intraoperative chest radiograph showing normal left lung field.
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The surgeon then inserted an intercostal tube immediately on the right side, and another chest X-ray taken afterwards showed satisfactory lung expansion (Figure 4).
Intraoperative chest radiograph after insertion of intercostal tube showing normal lung expansion.
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The patient was discharged to the surgical ward, and follow-up chest X-ray was done on the following day, showing proper intercostal tube placement and proper lung expansion (Figure 5).
Postoperative computed tomography (CT) scan showing minimal right-side residual pneumothorax and the intercostal tube in place.
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Computed tomography (CT) scan was done on postoperative day 2 showing minimal pneumothorax, normal architecture of the trachea, and the bronchial tree, no evidence of bullae, no evidence of pneumomediastinum, and a right hepatic laceration (Figure 6).
Follow-up chest radiograph showing no evidence of recurrence of pneumothorax.
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The intercostal tube was removed on postoperative day 3 (Figure 7), and the patient was discharged home on day 4 postoperatively.