# Acute Negative Pressure Pulmonary Edema Following Upper Gastrointestinal (GI) Endoscopy: A Case Report

## TL;DR

A 65-year-old woman developed acute pulmonary edema after a digestive endoscopy without intubation, which was successfully treated with oxygen and diuretics.

## Contribution

This case report highlights a rare instance of negative pressure pulmonary edema occurring outside of orotracheal intubation.

## Key findings

- Acute pulmonary edema occurred after upper GI endoscopy under sedation without tracheal intubation.
- Transthoracic echocardiography ruled out cardiac causes of the edema.
- Conservative treatment with oxygen and diuretics led to rapid clinical improvement.

## Abstract

Acute pulmonary edema with negative pressure (APENP) is a rare respiratory complication caused by acute upper airway obstruction, most often occurring during the postoperative period.

We report a case of acute pulmonary edema with negative pressure outside of orotracheal intubation, occurring in a 65-year-old Moroccan woman, admitted for respiratory distress following digestive endoscopy under sedation without tracheal intubation. A chest X-ray after the procedure showed diffuse bilateral alveolar syndrome. Transthoracic echocardiography ruled out cardiac origin. Management was based on oxygen therapy with diuretics without the need for mechanical ventilation. The clinical assessment showed rapid improvement, and a second chest X-ray on the second day of treatment demonstrated a good resolution of the initial alveolar syndrome.

A good understanding of this pathological entity allows for a quick diagnosis and optimal management of this complication.