Pneumothorax ex vacuo

Pneumothorax ex vacuo is an uncommon complication of lobar lung collapse, particularly right upper lobe collapse.

Patients are usually asymptomatic 3

Acute bronchial obstruction for any reason, such as bronchogenic carcinomasmucus plugs, foreign bodies, or malpositioned endotracheal tubes, can cause acute lobar collapse and a marked increase in negative intrapleural pressure around the collapsed lobe which results in gas being drawn into the pleural space around the collapsed lobe while the seal between the visceral and parietal pleura remains intact.

It is also seen following removal of a pleural effusion by thoracocentesis, when the collapsed lung struggles to re-expand. It is thought that this type of ex vacuo pneumothorax occurs because (a) co-existing pleural disease precludes normal re-expansion of the lung (b) pulmonary surfactant is insufficient 4.

See article on pneumothorax. Also maybe signs of lung collapse.

The pneumothorax spontaneously resolves when the bronchial obstruction is relieved and the lobe re-expands. Treatment is alleviation of the obstruction and chest drain insertion is not usually required.

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Article information

rID: 36767
System: Chest
Tag: refs, cases
Synonyms or Alternate Spellings:
  • Ex vacuo pneumothorax

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