CTICasesNegative Pressure Pulmonary Edema after Upper Airway Obstruction during Septoplasty
[...]. Negative Pressure Pulmonary Edema after Upper Airway Obstruction during Septoplasty. CTICases. Published October 23, 2026. https://cticases.com/c/w5p6g
Imaging findings
The first radiograph shows a bat-wing perihilar opacity that clears within days. CT shows dependent dense ground-glass with an interlobular gradient, septal sparing and peripheral lymphatic sparing, with the fluid appearing mobile. The trachea is abnormal, with bowed anterior cartilage and a mildly narrowed inlet.
Key takeaways
Strong inspiratory effort against an obstructed upper airway during anaesthesia generates large negative intrathoracic pressure, which pushes fluid into the alveoli and causes hydrostatic pulmonary edema that clears quickly. Laryngospasm is the usual trigger. The dependent gradient and septal sparing point to fluid rather than aspirate, and the suction and airway injury may have contributed.
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