Intraoperative contralateral tension pneumothorax during pneumonectomy.

Unrecognized tension pneumothorax can have catastrophic consequences. We report a case of a patient who developed a contralateral tension pneumothorax during thoracotomy without the classic signs of marked hypoxemia and hemodynamic instability. A tension pneumothorax should be considered in any patient who develops high peak inspiratory pressures during one-lung ventilation with an open chest, even in the absence of the classic signs of hypoxemia and hypotension.