The Impact of the Lung Ultrasound on the Diagnosis of Interstitial Pulmonary Edema Before Extubation After Gynecologic Laparoscopic Surgery in the Trendelenburg Position: A Case Report

Lung ultrasound contributes to the diagnosis of perioperative pulmonary edema due to fluid overload and impairment of renal function. Laparoscopic surgery and the patient's intraoperative position can facilitate the emergence of these disturbances as well. A 34-year-old female patient underwent laparoscopic salpingectomy and ovarian resection in the Trendelenburg position because of an unruptured ectopic pregnancy. The large fluid volume administration pre- and intraoperatively and the intraoperative low urine output led to the development of interstitial pulmonary edema before extubation. The formation of comet-tail lines at the lung ultrasound indicated the administration of diuretic therapy, followed by the improvement of the patient's cardiopulmonary status, urine excretion, and extubation. A subsequent chest X-ray verified the foregoing findings. Lung ultrasound enables the quick and accurate diagnosis of interstitial edema. The early administration of diuretic therapy eliminates the potential of the patient's prolonged postoperative hospitalization, even in the intensive care unit.