Tension pneumothorax mimic due to right lower lobe hypoplasia

Case contributed by Dr Brendon Friesen

Presentation

Code blue. Recent pacemaker insertion

Patient Data

Age: 70 years
Gender: Female

Left pneumothorax. Mediastinal shift towards right, depression of left hemidiaphragm, concerning for tension pneumothorax.

Pacemaker, ETT, nasogastric tubes.

Chest radiograph prior to pacemaker insertion (previous day). Rightward mediastinal shift. Defibrillation pad noted. No pneumothorax

Comparison radiograph from 10 years previous - cardiomediastinal contour is unchanged (likely right lower lobe hypoplasia).

Left sided pneumothorax and left sided intercostal catheter.

Only minor right basal subsegmental atelectasis.

Case Discussion

Left sided pneumothorax complicating pacemaker insertion. Despite the clinical scenario of code blue (possibly related to pneumothorax), the rightward mediastinal shift is unchanged since 10 years previous (possibly right lower lobe hypoplasia), mimicking radiographic features of tension pneumothorax.

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Case information

rID: 30073
Published: 16th Jul 2014
Last edited: 14th Aug 2019
System: Chest
Inclusion in quiz mode: Included

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