Basal pneumothorax and trapped lung post thoracentesis
Chronic left pleural effusion. Post thoracocentesis.
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Left basal pneumothorax with air-fluid level and mensiscus indicating that this is actually a hydropneumothorax. Left chest wall subcutaneous emphysema. Left upper and lower lobe atelectasis. Right upper lobe granuloma.
Most pneumothoraces post ultrasounded-guided thoracentesis (which are uncommon in themselves) result from unavoidable stress-related parenchymal-pleural fistulas that result from trapped (unexpandable) lung rather than being procedure related (e.g. direct lung puncture, poor technique).
Radiographic signs of trapped lung include:
- visceral pleural peel (thickening)
- basilar pneumothorax
- ipsilateral volume loss
- lobar atelectasis
Often treatment of these pneumothoraces with chest tubes is unsuccessful and most will slowly resolve in their own time.
- 1. Heidecker J, Huggins JT, Sahn SA et-al. Pathophysiology of pneumothorax following ultrasound-guided thoracentesis. Chest. 2006;130 (4_MeetingAbstracts): 1173-84. doi:10.1378/chest.130.4.1173 - Pubmed citation
- 2. McDermott S, Levis DA, Arellano RS. Chest drainage. Semin Intervent Radiol. 2012;29 (04): 247-55. doi:10.1055/s-0032-1330058 - Free text at pubmed - Pubmed citation