E S Kerns1, S A Alobaidi, K Roayaie, J S Obhrai. 1. Departments of Nephrology, Hypertension, & Transplantation, Oregon Health & Science University, Portland, Oregon.
Abstract
BACKGROUND: Chest pain in kidney transplant recipients can signify a life-threatening condition. CASE REPORT: A patient with polycystic kidney disease who underwent living donor kidney transplantation with open bilateral native nephrectomy developed acute substernal chest pain 10 days post-transplantation. History, physical, and diagnostic studies identified no cardiac or pulmonary causes for the pain, but radiography showed mediastinal air. No vascular or thoracic injury explained the development of the pneumomediastinum. After 1 day on oxygen, the chest pain symptoms resolved. Repeat x-rays showed resolution of the pneumomediastinum. DISCUSSION: Pneumomediastinum resulting from air migrating from the abdominal cavity to the thorax has not been described after open removal of diseased abdominal organs. This case illustrates that creation of a potential space in the abdominal cavity can be associated with the development of pneumomediastinum. CONCLUSIONS: Conservative measures were sufficient to resolve the pneumomediastinum and symptoms in this patient.
BACKGROUND:Chest pain in kidney transplant recipients can signify a life-threatening condition. CASE REPORT: A patient with polycystic kidney disease who underwent living donor kidney transplantation with open bilateral native nephrectomy developed acute substernal chest pain 10 days post-transplantation. History, physical, and diagnostic studies identified no cardiac or pulmonary causes for the pain, but radiography showed mediastinal air. No vascular or thoracic injury explained the development of the pneumomediastinum. After 1 day on oxygen, the chest pain symptoms resolved. Repeat x-rays showed resolution of the pneumomediastinum. DISCUSSION: Pneumomediastinum resulting from air migrating from the abdominal cavity to the thorax has not been described after open removal of diseased abdominal organs. This case illustrates that creation of a potential space in the abdominal cavity can be associated with the development of pneumomediastinum. CONCLUSIONS: Conservative measures were sufficient to resolve the pneumomediastinum and symptoms in this patient.
Authors: Gavriella Zoi Vrakopoulou; Victoria Michalopoulou; Christina-Evaggelia Kormentza; Maria Matiatou; K George Zografos; Konstantinos G Toutouzas Journal: Int J Surg Case Rep Date: 2020-05-08