Pneumothorax after Shoulder Arthroscopy: A Case Report

Abstract

Shoulder arthroscopy is an increasingly common procedure. Pneumothorax post-shoulder arthroscopy is a rare complication. Our aim is to highlight a case report of pneumothorax post-shoulder arthroscopy and to conduct a literature review to evaluate the possible risk factors. We report the case of a 75-year-old male non-smoker, who underwent right shoulder arthroscopy without regional anaesthesia in the left lateral position and subsequently suffered a pneumothorax post-operatively. A PubMed Medline and Cochrane database search was carried out, and 32 articles were identified and thoroughly reviewed. Overall, among the articles that propose a mechanism, 75% (9/12) consider the pathogenesis to be multifactorial. The exact mechanism is currently unknown. Awareness of this complication and timely recognition are important to prevent life-threatening sequelae. Surgeons should maintain a low threshold for obtaining diagnostic plain radiographs in the event of clinical suspicion.

Keywords: complication; decompression; pressure; rotator cuff repair.

Fig. 1:

Flow diagram of article selection.

Fig. 2:

(a) Pre-operative chest radiograph – normal lung field expansion with no visible bullae noted. (b) Post-operative chest radiograph – right sided pneumothorax seen (indicated by arrow). (c) Chest radiograph post chest tube insertion (indicated by arrow) – with resolution of right sided pneumothorax seen.