Postoperative respiratory failure caused by acute exacerbation of idiopathic interstitial pneumonia.
Summary of "Postoperative respiratory failure caused by acute exacerbation of idiopathic interstitial pneumonia."
We herein report a case of postoperative respiratory failure caused by acute exacerbation of undiagnosed interstitial pneumonia (IP). A 76-year-old woman underwent two subsequent operations, cholecystectomy and resection of lipoma in the neck, under general anesthesia at an interval of 12 days. Although the postoperative course of the first operation was uneventful, the patient abruptly developed respiratory failure on the 4th postoperative day (POD) of the second operation. Although steroid therapy was transiently effective to improve oxygenation, respiratory failure was gradually deteriorated. She died on the 25th POD. She had a past history of right upper lobectomy for pseudotumor resulting from cryptogenic organizing pneumonia in another hospital 4 years ago. The follow-up CT performed in this hospital demonstrated subtle foci of ground-glass opacities in the left lung; however, no diagnosis of IP had been made. Thus, we concluded that idiopathic IP had gradually advanced preoperatively, and acute exacerbation was triggered by perioperative stress. The present case warned us that acute exacerbation of IP could occur in a patient with mild symptoms. Therefore, preoperative proper diagnosis is thought to be important as acute exacerbation of IP is a highly morbid clinical event.
Affiliation
Department of Anesthesia, Hachinohe Heiwa Hospital, 4-6 Minatotakadai 2-Chome, Hachinohe, 031-8545, Japan, kubota@heiwa-hp.or.jp.
Journal Details
This article was published in the following journal.
Name: Journal of anesthesia
ISSN: 1438-8359
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21487668
- DOI: http://dx.doi.org/10.1007/s00540-011-1132-5
Medical and Biotech [MESH] Definitions
Idiopathic Interstitial Pneumonias
A group of interstitial lung diseases with no known etiology. There are several entities with varying patterns of inflammation and fibrosis. They are classified by their distinct clinical-radiological-pathological features and prognosis. They include IDIOPATHIC PULMONARY FIBROSIS; CRYPTOGENIC ORGANIZING PNEUMONIA; and others.
Hantavirus Pulmonary Syndrome
Acute respiratory illness in humans caused by the Muerto Canyon virus whose primary rodent reservoir is the deer mouse Peromyscus maniculatus. First identified in the southwestern United States, this syndrome is characterized most commonly by fever, myalgias, headache, cough, and rapid respiratory failure.
Liver Failure, Acute
A form of rapid-onset LIVER FAILURE, also known as fulminant hepatic failure, caused by severe liver injury or massive loss of HEPATOCYTES. It is characterized by sudden development of liver dysfunction and JAUNDICE. Acute liver failure may progress to exhibit cerebral dysfunction even HEPATIC COMA depending on the etiology that includes hepatic ISCHEMIA, drug toxicity, malignant infiltration, and viral hepatitis such as post-transfusion HEPATITIS B and HEPATITIS C.
Kidney Failure
A severe irreversible decline in the ability of kidneys to remove wastes, concentrate URINE, and maintain ELECTROLYTE BALANCE; BLOOD PRESSURE; and CALCIUM metabolism. Renal failure, either acute (KIDNEY FAILURE, ACUTE) or chronic (KIDNEY FAILURE, CHRONIC), requires HEMODIALYSIS.
Heart Failure
A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION.
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