Diagnostic Dilemma in a Case of Pneumothorax after Brachial Plexus Block

This article explores the application and implications of ultrasound-guided brachial plexus blockade in a trauma patient with upper extremity injury and blunt chest trauma. A 33-year-old male patient, involved in a road traffic accident, presented with a Galeazzi fracture and chest trauma but no significant comorbidities. Despite stable intraoperative vitals under ultrasound-guided brachial plexus block for an open reduction and internal fixation with plating, the patient developed postoperative complications including difficulty in breathing and decreased oxygen saturation, leading to the diagnosis of bilateral pneumothorax. Subsequent imaging revealed multiple rib fractures, necessitating the placement of an intercostal chest drain. This case highlights the potential for delayed onset pneumothorax in blunt chest trauma patients, posing diagnostic challenges in the postoperative setting. The findings underscore the necessity of vigilant postoperative monitoring and the potential benefits and risks associated with regional anesthesia in trauma-induced surgeries.