Longoedeem na een tentamen suicidii: postobstructief longoedeem

Matthijs P. Somford, Frits J. Schuitemaker en Dagmar I. Vos

Lung oedema following an attempted suicide: postobstructive lung oedema

A 32-year-old man was brought to the Accident and Emergency Department after attempted suicide by hanging. Within a short time he developed extensive lung oedema without any sign of cardiac pathology. This condition is called postobstructive pulmonary oedema and is observed after an upper airway obstruction. The oedema develops because of a highly negative intrathoracic pressure, an increased venous return to the heart and an increased pulmonary capillary hydrostatic pressure. The treatment of postobstructive pulmonary oedema is supportive and consists of the administration of oxygen and, if necessary, mechanical ventilation. The patient recovered from the oedema but died a few days later from the consequences of irreversible hypoxic ischaemic brain damage. The possibility of postobstructive pulmonary oedema should be considered in cases of unexplained non-cardiac lung oedema, especially in the case of young men who have breathed against a resistance.