This patient was admitted to intensive care following a pulmonary valve replacement. The pneumothorax was noted on admission chest x-ray. The patient was asymptomatic. The surgical team state they did not breach the right hemithorax and had good vision of it at all times.

Suspected iatrogenic pneumothorax from right internal jugular central venous device insertion. 

The patient was monitored and the pneumothorax resolved without requiring an intercostal catheter. A three-way valve dressing was applied to the soft tissue tract when the central venous access device was removed.