Tension pneumothorax and pneumomediastinum

Case contributed by Dr Pir Abdul Ahad Aziz Qureshi

Presentation

Worsening shortness of breath.

Patient Data

Age: neonate
Gender: Male

Portable chest x-ray with a large left-sided pneumothorax. The left lung is collapsed with a contralateral shift of the mediastinum and depressed ipsilateral hemidiaphragm consistent with tension pneumothorax. Air is also seen outlining the heart and thymus (spinnaker sign) representing pneumomediastinum. Minimal air is seen projecting within subcutaneous tissues along the left lateral chest wall suggestive of subcutaneous emphysema.

Case Discussion

Tension pneumothorax is a medical emergency and requires immediate relieving of tension by inserting a cannula or a needle typically in 2nd intercostal space.

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