Pneumothorax (asthma)

Case contributed by Dr Jeremy Jones


Acutely unwell with respiratory compromise requiring intubation and ventilation.

Patient Data

Age: 13
Gender: Male

ET tube and NG tube in situ and in appropriate positions. 

The lungs are hyperexpanded with flattening of the diaphragms. Appearances suggest background of asthma. At both apices, the lung edge can be seen with no lung markings peripherally. Features here are of small bilateral pneumothoraces.

Annotated image

With a bit of windowing and zoom, both the apical pneumothoraces becomes much more obvious.

Case Discussion

The lungs are hyperexpanded and in a young patient, this should trigger thoughts of asthma. With asthmatic patients, look for a cause of their exacerbation (e.g. viral chest infection), but also look for secondary complications (e.g. pneumothorax, pneumomediastinum, surgical emphysema).

In the case of pneumothorax, use a good monitor, good viewing conditions and window to give yourself the best chance of finding it. Pneumothoraces are most likely to be apical in these patients, so give it a bit of zoom too.

Pneumothoraces are more common in asthmatics, but may also be the result of over-ventilation, either by hand-bagging or mechanical-ventilation.

PlayAdd to Share

Case information

rID: 27447
Published: 22nd Apr 2014
Last edited: 17th Oct 2020
System: Paediatrics
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.