Resuscitation on a Commercial Flight Due to a Large Bronchogenic Cyst

A 31-year-old female patient experienced a strong sensation of pressure in the chest while on a flight home from vacation and suffered circulatory arrest as the aircraft prepared to land. Following chest compressions on board, the subsequent determination of cause found only a large cystic mass in the left upper lobe of lung (Figure). Histology of the primarily resected mass revealed an intrapulmonary bronchogenic cyst measuring 90 mm in diameter. This congenital malformation is usually asymptomatic. Infection of the contents of the cyst can lead to the development of symptoms with enlargement of the cyst. In the present case, the cyst no longer communicated with the bronchial system: the reduced cabin pressure in the aircraft caused the cyst to increase in size at the beginning of the flight, which very likely resulted in compromised venous return to the heart or, alternatively, vasovagal syncope. The otherwise healthy patient’s circulation decompensated over the course of the flight, collapsing in the final phase before the cyst could reduce in size again when the cabin pressure increased as the aircraft made its approach to land.

Figure

Coronal reconstruction of a contrastenhanced computed tomography of the chest

Anton Popov, Dr. med. Henning Busk, Prof. Dr. med. Thorsten Walles, Klinik für Herz- und Thoraxchirurgie, Abteilung Thoraxchirurgie, Universitätsmedizin Magdeburg

Conflict of interest statement: The authors state that no conflict of interest exists.

Translated from the original German by Christine Rye.

Cite this as: Popov A, Busk H, Walles T: Resuscitation on a commercial flight due to a large bronchogenic cyst. Dtsch Arztebl Int 2021; 118: 834a. DOI: 10.3238/arztebl.m2021.0132