Pneumothorax with an azygos lobe
Fell from standing height.
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The inferior portion of the azygos vein is hypoplastic, with a compensatory increase in size of the hemiazygos vein. A pneumothorax is seen extending under the fissure of an azygos lobe. Air is also seen outlining the azygoesophageal recess.
Despite azygos lobes occurring in up to 1% of people, reports of pneumothorax in patients with such variant anatomy are surprisingly rare 1-3. The pneumothorax here helps appreciate the anatomy of the azygos vein connecting with the superior vena cava, drawing down with it a thick double layer of pleura.
- 1. Sadikot RT, Cowen ME, Arnold AG. Spontaneous pneumothorax in a patient with an azygos lobe. (1997) Thorax. 52 (6): 579-80; discussion 575-6. Pubmed
- 2. Weissman JL, Austin JH. Pneumothorax and an azygos lobe. (1989) Journal of thoracic imaging. 4 (1): vi-ix. Pubmed
- 3. Asai K, Urabe N, Takeichi H. Spontaneous pneumothorax and a coexistent azygos lobe. (2005) The Japanese journal of thoracic and cardiovascular surgery : official publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai zasshi. 53 (11): 604-6. Pubmed