Tension spontaneous pneumothorax

Case contributed by Hidayatullah Hamidi
Diagnosis certain


Chronic cough and weight loss. Dyspnea for one day.

Patient Data

Age: 20 years
Gender: Female

Massive right sided pneumothorax with mediastinal shift to the left side.

Complete collapse of the right lung. There are cavitary changes in the right lung upper lobe.

Multifocal opacity in left lung upper lobe apico-posterior segment as well as in the superior segment of left lung lower lobe.

Prominent subcarinal lymph nodes.

Case Discussion

The overall features are in favor of chronic lung infection with a right sided tension pneumothorax likely due to rupture of the upper lobe cavity.

Keeping with the chronic history, distribution of the pulmonary change and the endemic area of tuberculosis (Afghanistan); the underlying infection is more likely secondary tuberculosis. 

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