Acute pulmonary edema caused by choking in an adult patient

Postobstructive pulmonary edema (POPE), otherwise known as negative pressure pulmonary edema (NPPE), is a potentially life-threatening complication following acute upper airway obstruction (UAO). It can develop rapidly, without warning, in persons who are otherwise well. Although POPE was first described nearly 30 years ago, yet this perplexing syndrome is rarely reported in adult. We report an adult patient who suffered from choking with a Chinese dessert. He developed a non-cardiogenic pulmonary edema due to acute upper airway obstruction and recovered well after conservative treatment. Clinicians should be alert to continued respiratory symptoms following relief of acute airway obstruction. Preventing re-obstruction and providing adequate ventilation and oxygenation are mandatory. Such patients should be observed in ED for at least 6 hours in order to avoid a catastrophic outcome. Awareness of this condition can avoid unnecessary intervention and possible iatrogenic complications coming from treating ALI/ARDS.