Case Report and Literature Review: Post-Arthroscopy Pneumothorax with Anterior Decompression

• Main Authors: Marc A. Cassone, Kristin L. Kish, Jordan R. Nester, Lisa M. Hoffman
• Format: Article
• Language: English
• Published: eScholarship Publishing, University of California 2020-11-01
• Series: Clinical Practice and Cases in Emergency Medicine
• Online Access: https://escholarship.org/uc/item/90k089sz

Introduction: Emergency providers should recognize that pneumothorax is a rare but serious complication of shoulder arthroscopy that may require a unique approach to decompression. Case Report: We present a case of a 60-year-old female who presented to the emergency department with right-sided facial swelling, voice change, and shortness of breath three hours after an elective arthroscopic right rotator-cuff repair and was noted to have a right-sided pneumothorax. We also describe a potential novel approach to chest tube decompression that maintains shoulder adduction in patients with recently repaired rotator cuffs. Conclusion: Although most cases of post-arthroscopy pneumothoraces are reported in patients who received regional anesthesia or have underlying lung pathology, it can occur in lower-risk patients as was demonstrated in our case. We also suggest considering an alternative anterior approach between the midclavicular and anterior axillary lines for chest decompression in select patients when a traditional approach is less ideal due to the need to maintain shoulder immobilization postoperatively.