Cystic fibrosis with pneumothorax

Case contributed by Dr Jeremy Jones

Presentation

Cystic fibrosis and a non-resolving pneumothorax despite having a drain in situ for 4 days. Surgical planning scan.

Patient Data

Age: 20 years
Gender: Male

Left sided pneumothorax with a drain in situ and associated surgical emphysema. Right sided Port-a-cath. The lungs have course bronchovascular markings with upper lobe ring shadows, both features of CF and underlying bronchiectasis.

Pneumothorax and drain demonstrated with surgical emphysema.  

Background changes of cystic fibrosis with bronchial wall thickening and dilatation of upper lobe bronchi. They are larger than their accompanying vessels and do not taper appropriately, both features of bronchiectasis.

Case Discussion

The chest radiograph confirms the persistent pneumothorax with the chest drain in situ and associated surgical emphysema.  The right sided Port-a-cath is a common finding in patients with cystic fibrosis.

The CT confirms the pneumothorax and the position of the drain. The ring-shadows demonstrated on the plain film are confirmed as upper lobe bronchiectasis.

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