Tension pneumothorax

Case contributed by Dr Tom Foster

Presentation

Breathless and left sided chest pain, following a 'popping' sensation in his chest the previous day.

Patient Data

Age: 20 years
Gender: Male
X-ray

Initial imaging

Large left sided pneumothorax, with tracheal deviation and mediastinal shift to the right. Flattening of the left hemidiaphragm. Appearances in keeping with left tension pneumothorax.

X-ray

Post-aspiration and chest drain insertion

Improved appearances following needle aspiration and left intercostal chest drain insertion. Small residual apical pneumothorax on the left. Left basal atelectasis.

The trachea/mediastinum is no longer deviated to the right.

Case Discussion

A left sided tension pneumothorax, arguably the patient should have never had this X-ray! Thankfully, he underwent needle aspiration immediately after this radiograph was taken and following this, insertion of intercostal chest drain.

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Case information

rID: 73655
Published: 17th Jan 2020
Last edited: 8th Jul 2020
System: Chest
Inclusion in quiz mode: Included
Institution: NHS Lothian

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