Reexpansion pulmonary edema after resolution of tension pneumothorax in the contralateral lung of a previously lung injured patient.

We present the case of a 19-year-old woman who developed sudden severe left-sided tension pneumothorax in the recovery room after undergoing a 6-hour open reduction and internal fixation of an anterior and posterior pelvic fracture sustained in a motor vehicle accident 4 days prior to surgery. Additional preoperative injuries included a right-sided hemopneumothorax, right lung contusion, and liver laceration. The left lung was rapidly reexpanded using tube thoracostomy. The patient subsequently developed ipsilateral pulmonary edema and ultimately acute respiratory distress syndrome, which required vigorous treatment over the next several days. It is postulated that a variety of intraoperative and immediate postoperative maneuvers may have contributed to the development of this near fatal complication.