A 65-year-old male diabetic patient underwent transhiatal oesophagectomy and gastric resection for adenocarcinoma of the gastro-oesophageal junction. On the 10th postoperative day, he developed progressive breathlessness which became severe by the next day. Air entry was significantly reduced on the left hemithorax as evidenced from chest X-ray (Image attached).The patient was rushed for an emergency thoracolaparotomy. Clinical examination The patient had severe respiratory distress with an inability to lie down, nasal flaring, active accessory muscles, sweating and dilated neck veins. The respiratory rate was 40/min.
The pulse was thready with a rate of 180/min and blood pressure of 90/60 mmHg. He maintained oxygen saturation of 85-90% with supplemental oxygen of 6 l/min. The patient was pre-oxygenated and induced in sitting position. Fluid resuscitation was initiated. The airway was…
