Spontaneous pneumothorax

Case contributed by Dr Adam Ramsey

Presentation

Chest pain and shortness of breath whilst laying on the couch watching TV.

Patient Data

Age: 70 years
Gender: Male
X-ray

Day 1 on presentation

A fairly large right-sided pneumothorax is noted. No tracheal deviation. Left lung field appears clear.

X-ray

Day 1 following chest tube placement

There is interval placement of a right-sided chest tube with pigtail tip seen within the right lower lung field oriented downward. There is an approximately 20-35% right-sided pneumothorax seen, which is improved from previous exam. The left lung field appears fairly clear.

X-ray

Day 2

There is continued re-expansion of the right lung. The pneumothorax seen on the prior study is no longer identified.

CT

There is a right sided pneumothorax involving approximately 10% lung volume. There is also a subcutaneous emphysema overlying the right anterior chest wall likely related to the chest tube.

Case Discussion

Spontaneous pneumothorax was found in this patient who has a 50 pack year smoking history and scattered emphysematous and fibrotic changes throughout his lungs. 

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Case information

rID: 71579
Published: 12th Oct 2019
Last edited: 13th Oct 2019
System: Chest
Inclusion in quiz mode: Included
Institution: Arnot Ogden Medical Center

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