Abstract
RATIONALE: This article describes a case of acute pulmonary edema in a young patient who underwent laparoscopic appendectomy under general anesthesia. Written informed consent was obtained from the patient. PATIENT CONCERNS: A 25-year-old male patient underwent laparoscopic appendectomy under general anesthesia. Thirty minutes after endotracheal tube removal, the patient developed acute respiratory distress symptoms, became agitated, experienced decreased oxygen saturation, and produced pink, frothy sputum. DIAGNOSES: Both lungs were auscultated, and bilateral breath sounds were weakened. Clear, wet rales were heard, and chest computed tomography confirmed bilateral pulmonary edema. INTERVENTIONS: High-flow oxygen therapy via face mask, corticosteroid treatment to control inflammation, diuretics to reduce pulmonary edema, and other symptomatic treatments were administered. OUTCOMES: The patient's condition stabilized and he was discharged after 9 days with no long-term complications. LESSONS: Although acute pulmonary edema after routine laparoscopic surgery in young patients is very rare, caution should be exercised in the early stage after removing the endotracheal tube. Meticulous perioperative fluid management, optimization of extubation techniques to prevent airway obstruction, rigorous postoperative monitoring, maintenance of high vigilance, and prompt intervention are essential to prevent serious consequences.