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Chest Pain After Kidney Transplantation Owing to Pneumomediastinum: A Case Report
Authors:E.S. Kerns  S.A. Alobaidi  K. Roayaie  J.S. Obhrai
Affiliation:1. Departments of Nephrology, Hypertension, & Transplantation, Oregon Health & Science University, Portland, Oregon;2. Abdominal Organ Transplantation & Hepatobiliary Surgery, Oregon Health & Science University, Portland, Oregon
Abstract:

Background

Chest pain in kidney transplant recipients can signify a life-threatening condition.

Case Report

A patient with polycystic kidney disease who underwent living donor kidney transplantation with open bilateral native nephrectomy developed acute substernal chest pain 10 days post-transplantation. History, physical, and diagnostic studies identified no cardiac or pulmonary causes for the pain, but radiography showed mediastinal air. No vascular or thoracic injury explained the development of the pneumomediastinum. After 1 day on oxygen, the chest pain symptoms resolved. Repeat x-rays showed resolution of the pneumomediastinum.

Discussion

Pneumomediastinum resulting from air migrating from the abdominal cavity to the thorax has not been described after open removal of diseased abdominal organs. This case illustrates that creation of a potential space in the abdominal cavity can be associated with the development of pneumomediastinum.

Conclusions

Conservative measures were sufficient to resolve the pneumomediastinum and symptoms in this patient.
Keywords:
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