Large pneumothorax with no mediastinal shift

Case contributed by Assoc Prof Craig Hacking

Presentation

Acute chest pain.

Patient Data

Age: 25 years
Gender: Male

Large left pneumothorax with complete collapse of the left lung. Increased volume of the left hemithorax but no mediastinal shift.

Case Discussion

Typical features of increased hemithoracic volume with increased rib spacing and depression of the hemidiaphragm but remarkably there is no mediastinal shift. Incredibly the patient was only mildly hypoxic and only complained of 6/10 pleuritic chest pain. 

This case illustrates an important concept: tension pneumothorax is a CLINICAL diagnosis. Despite the signs of increased volume due to the large pneumothorax, the diagnosis of tension require appropriate clinical signs.

The patient was treated successfully with an ICC for 2 days.

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Case information

rID: 72976
Published: 2nd Jan 2020
Last edited: 2nd Jan 2020
System: Chest
Inclusion in quiz mode: Included

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