Tension pneumothorax

Case contributed by Emily Mulder
Diagnosis certain


Post endotracheal tube placement with known COVID pneumonia.

Patient Data

Age: 40 years
Gender: Female

XR Chest


Interval placement of endotracheal tube terminating 3 cm from the carina. Large right tension pneumothorax and scattered mediastinal lucencies are seen. The cardiomediastinal silhouette is shifted into the left hemithorax. The pulmonary vasculature is obscured. Complete collapse of right lung. Diffuse patchy airspace opacities in the left hemithorax. No pleural, osseous or soft tissue abnormalities.

Post chest tube placement


Interval placement of a right-sided chest tube with interval improvement of the right-sided tension pneumothorax. Tiny residual apical pneumothorax. Bilateral diffuse hazy airspace disease, consistent with known viral pneumonia

Case Discussion

This patient with viral pneumonia was diagnosed with a large right tension pneumothorax, with complete collapse of the right lung and leftward shift of the cardiac mediastinal silhouette. 

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