April 15, 1968

Pneumothorax Following Subdiaphragmatic Surgery

Author Affiliations

From the Department of Anesthesia, University of California Medical Center, San Francisco.

JAMA. 1968;204(3):255-256. doi:10.1001/jama.1968.03140160065018

The following four cases are presented as evidence that "unusual" complications occur with surprising frequency.

Report of Cases 

Case 1.—  A 21-year-old man in excellent health was anesthetized for a nephrectomy on the left side. The operation was performed to obtain a kidney for transplant to a sibling. The patient was of small stature and presented no unusual problem for the surgeon or anesthetist. The operation was performed without event with the patient in the lateral position and with the kidney rest elevated. A subcostal incision on the left side was utilized and the 11th rib resected. Anesthesia was accomplished with fluroxene supplemented by tubocurarine chloride. Respiration was manually controlled. Near the termination of the procedure, the surgeon requested hyperinflation of the lungs. This was accomplished easily and revealed nothing unusual. When the incision was closed, atropine sulfate and neostigmine methylsulfate were administered until curarization was satisfactorily reversed. The endotracheal