Radiology for the Surgeon: Pneumothorax
Pneumothorax (click to enlarge images)
History: Shortness of breath for one week.
Frontal upright chest x-ray with expiration on image 1 demonstrating a large right sided pneumothorax. The majority of the ipsilateral hemithorax is lucent with a partially collapsed lung (white arrows). Air in the pleural space outlines the visceral pleura overlying the collapsed lung and the parietal pleura overlying the lateral chest wall. There is only mild shift of the mediastinum to the contralateral side.
Frontal upright chest x-ray on image 2 demonstrating the interval placement of a right chest tube and near complete expansion of the right lung. Notice the small apical pleural air collection (white arrow).
Incidental findings include a small pleural effusion on right, bilateral hyperaeration with emphysema, and bilateral interstitial attenuation. The spontaneous pneumothorax was likely secondary to chronic or pre-existing lung disease.
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OnSurg thanks contributing radiologist Dr Jude Longo for images and descriptions.