Acute upper airway obstruction can cause negative pressure pulmonary edema (NPPE). It is a well-known perianesthetic complication, but is uncommon for intubated patients. Radiation injury of lung can easily lead to pulmonary hemorrhage or NPPE caused by changes of transthoracic or transpulmonary pressure. It is due to injury of alveolar-capillary membrane by radiation. We report the case of a 71-year-old man with a history of radiation therapy for lung cancer after surgical resection who developed the abrupt onset of pulmonary hemorrhage and NPPE during general anesthesia for hydrocele and inguinal hernia operation.

• 이명수(광주기독병원 마취통증의학과, Department of Anesthesiology and Pain Medicine, Gwangju Christian Hospital, Korea) | Myung Su Lee
• 박천희(광주기독병원 마취통증의학과, Department of Anesthesiology and Pain Medicine, Gwangju Christian Hospital, Korea) | Cheon Hee Park
• 안태훈(조선대학교 의과대학 마취통증의학과 교실, Department of Anesthesiology and Pain Medicine, School of Medicine, Chosun University, Korea) | Tae Hun An Corresponding author