Win an All-Access Pass!
Become a new yearly Curie (Radium) or Roentgen (Gold) Radiopaedia Supporter during December and be in the running to win one of four 12-month All-Access Passes. Find out more.

Tension pneumothorax

Case contributed by Dr Andrew Ho


Acute decrease oxygen saturation and tachycardia in this intubated ICU patient.

Patient Data

Age: 20 years
Gender: Male

Portable frontal radiography reveals a large right pneumothorax with marked shift of the mediastinum to the left as demonstrated by the leftward deviation of the endotracheal tube, trachea and cardiac silhouette.

Case Discussion

Tension pneumothorax is a medical emergency and defined as the presence of a pneumothorax AND hemodynamic compromise.

This intubated ICU patient developed spontaneous pneumothorax and was presumed to be iatrogenic due to high-pressure ventilation.  The left central venous catheter has been in place for several days without any complications and was not likely the cause of the pneumothorax.

A rough guideline for communicating the size of the pneumothorax to the clinician is based on the maximal pleural separation from the chest wall: small (< 2 cm) vs large (>2 cm) 1.

PlayAdd to Share

Case information

rID: 23278
Published: 1st Jun 2013
Last edited: 14th Aug 2019
System: Chest
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.