Sudden exacerbation of a minimal hemothorax during emergence from general anesthesia: diagnosis using lung ultrasound
Year: 2026
Type: article
Study design: Case Report
Abstract: Minimal traumatic hemothoraces are generally stable but can be exacerbated by physiological shifts during the perioperative period.However, sudden deterioration during emergence from general anesthesia is rarely reported.A 62-year-old man with multiple rib fractures and a small pre-existing hemothorax underwent clavicle fracture fixation.Although hemodynamically stable intraoperatively, he developed severe agitation and forceful inspiratory efforts against airway obstruction during emergence, causing oxygen saturation to drop to 83%.Following airway maneuvers, saturation recovered to 95% and the patient was extubated.However, saturation subsequently declined to 90% despite 100% oxygen supplementation.Lung ultrasound promptly revealed pleural fluid accumulation and absent lung sliding, enabling rapid diagnosis of hemothorax.Chest tube insertion drained a total of 880 mL of blood and stabilized the patient.This case highlights that even a minimal hemothorax can worsen during emergence due to abrupt intrathoracic pressure shifts, and that point-of-care ultrasound enables immediate perioperative diagnosis and intervention.
Authors: Woojin Kwon, Seokhee Hwang
Institutions: Konyang University, Konyang University Hospital
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7171362642