Spontaneous pneumothorax during vaginal hysterectomy in lithotomy with steep Trendelenburg position—a case report

Abstract Background Pneumothorax associated with a steep head-down position in vaginal hysterectomy surgery is rare but can cause life-threatening complications. Case presentation We report case of female patient no obvious lung pathology who suffered intraoperative pneumothorax prolonged Trendelenburg position. To the best our knowledge, this first well-documented association. A 53-year-old female, diagnosed as recurrent umbilical hernia cystocele and rectocele was planned for anterior perineorrhaphy posterior colpoperineorrhaphy along open mesh repair under general anaesthesia. Approximately 90 min after position, peak inspiratory pressure increased, while oxygen saturation decreased. The airway pressures remained continuously on higher side whole throughout despite an interrupted propped-up between. could not be extubated shifted to intensive care unit (ICU) where ultrasonography (USG) chest x-ray showed signs pneumothorax. Intercostal tube drainage (ICTD) placed, improved dramatically. It suspected that period led persistently raised subsequent development Conclusions develop circumstances even if are safety range. So, careful monitoring immediate treatment necessary prevent condition from worsening anaesthesiologists must aware such potential danger.