Type II POPE develops after surgical relief of chronic upper airway obstruction. Reported causes include tonsillectomy 1 and removal of upper airway tumors. Clinical signs include tachypnea, tachycardia, rales and ronchi. Type II POPE develops soon after relief of chronic upper airway obstruction. The incidence of POPE is difficult to ascertain.
Most reports are of single cases or case series.
Twenty children developed pulmonary edema. POPE can present as a radiologic finding alone, suggesting that many cases may not be identified clinically. While these series represent experiences in a tertiary care setting, the surprising frequency of POPE suggests that it is not rare. I is multifactorial. 3,18,19 Forceful attempts to inhale against an obstruction create highly negative intrathoracic pressure, which causes increased venous return, decreased cardiac output and fluid transudation into the alveolar space.