Post lung biopsy pneumothorax

Case contributed by Dr Craig Hacking

Presentation

2 hours post CT guided lung Bx. Desat and subcut emphysema.

Patient Data

Age: 63
Gender: Male
X-ray

Large left pneumothorax with mediastinal shift indicating tension. Left upper lobe cavitating lesion, the lesion which was recently biopsied. Extensive left chest wall and neck surgical emphysema.

The patient had an ICC inserted immediately.

The patient had been lying decubitus (right side down) despite instructions not to.

Case Discussion

Pneumothorax is a known and relatively common complication of CT guided lung biopsy, however tension is fortunately less common. This patient showed clinical signs which lead to this CXR.

Routinely a CXR is performed at 4 hours post biopsy at the author's institution and the patient nursed decubitus with the side of biopsy down (to reduce the occurrence of pneumothorax).

This patient however was nursed left side up due to pain.

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Case information

rID: 37183
Case created: 28th May 2015
Last edited: 21st Sep 2016
Tag: ptx
Inclusion in quiz mode: Included

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