The IPC device had no significant impact on non-invasive blood pressure measurement of the ankle in our study.

We report a case of spontaneous hemothorax in a healthy 27-year-old man undergoing elective reconstruction of the right anterior cruciate ligament (ACL) under general anesthesia. In the postanesthesia care unit (PACU), the patient became hypotensive and tachycardic with mid-sternal chest discomfort. A chest roentgenogram revealed an almost complete opacification of the right hemithorax. A diagnostic thoracentesis was positive for frank blood, confirming a right hemothorax. The patient was emergently taken back to the operating room. A chest tube was inserted, and 3.3 l of dark blood was drained. Once the patient improved hemodynamically, we proceeded with a right video-assisted thoracoscopic surgery (VATS). A bleeding vessel incorporated in a bleb was identified at the apex of the right lung. The bleeding vessel was clipped. A wedge resection of the apical bleb was performed and the associated torn vascular adhesion was stapled. The patient was found to have bullous disease at the apical region of the right lung. These bullae can undergo neovascularization and form vascularized bullae. Rupture of these vascularized bullae can cause a spontaneous hemopneumothorax. In our patient it is possible that an apical vascularized bulla ruptured causing a massive intrapleural bleed.

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Cervical epidural steroid injection is accepted as one of several approaches to treat pain in the neck and upper extremities after traumatic nerve root irritation. We describe a case of intramedullary air in the high cervical spinal cord after cervical epidural steroid injection and discuss a possible etiology. A 16 year old female underwent cervical epidural steroid injection for cervical radiculopathy. Two days after the injection she presented with numbness and tingling in her upper and lower extremities. CT scan revealed an air bubble at the C2 level. Management included dexamethasone, gabapentin, and hyperbaric oxygen therapy. The air bubble dissipated and the patient's symptoms resolved.

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