Intraoperative rise in airway pressure during hysteroscopy: A diagnostic dilemma resolved by point-of-care ultrasound.

Abstract

A sudden increase in airway pressure during general anaesthesia commonly prompts evaluation for bronchospasm, endotracheal tube obstruction, circuit malfunction, pneumothorax or other respiratory causes. We report an unusual instance during hysteroscopy in which point-of-care ultrasound (POCUS) helped identify an unexpected intra-abdominal cause of deteriorating ventilation. A 46-year-old woman with type 2 diabetes mellitus and a history of previous open myomectomy was scheduled for relook hysteroscopy under general anaesthesia. Following induction and tracheal intubation, ventilation was initially satisfactory, with peak airway pressures of 18–20 cm H₂O.