No abstract

A 7-year-old male with hemoglobin SS disease and alpha thalassemia was admitted in preparation for a bone marrow transplant.Past medical history included repeated episodes of pain crisis, acute chest syndrome (ACS), silent infarcts, and a remote history of asthma, which was well controlled without medication. He presented for admission in his normal state of health and without complaints.The patient received one unit of RBCs by simple transfusion prior to placement of a temporary apheresis catheter. Surgery was uneventful (Figure S1 for chest X-ray post surgery). Postoperatively, the patient was awake with stable vitals and mild surgical pain. A few hours later, he had an episode of coughing and throat discomfort, which resulted in oxygen desaturations. Examination of the mouth and oral pharynx showed no edema or swelling. Chest X-ray at this time showed increased haziness in right lung fields (Figure S1). Presumed diagnosis was splinting due to postoperative pain leading to atelectasis.