Abstract
Spontaneous pneumothorax (SP) is a relatively common pathology in emergency medicine;
however, scant information is published regarding SPs developing tension physiology
in the literature. Risk factors for spontaneous pneumothorax include smoking, family
history, and underlying lung disease such as chronic obstructive lung disease (COPD),
cystic fibrosis, tuberculosis, among others. Treatment often involves conservative
management, needle aspiration, catheter placement, or tube thoracostomy. Tension pneumothorax,
however, is a life threatening condition requiring emergent intervention. Case reports
have demonstrated large SPs with midline shift but without tension physiology as patients
largely remained hemodynamically stable. We report the case of an 18-year-old male
presenting to the Emergency Department (ED) with a SP that rapidly developed tension
physiology with mediastinal shift and hypotension resolved by needle decompression
and CT placement.
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References
- BTS guidelines for the management of spontaneous pneumothorax.Thorax. 2003; 58: 39-52
- Spontaneous pneumothorax: epidemiology, pathophysiology and cause.Eur Respir Rev. Sep. 2010; 19: 217-219https://doi.org/10.1183/09059180.00005310
- Tension pneumothorax.Intensive Care Med. 1994; 20: 468-469
- Tension pneumothorax: diagnostic and therapeutic pitfalls.Crit Care Med. 1993; 21: 177-179
- Tension pneumothorax-time for a re-think?.Emerg Med J. 2005; 22: 8-16https://doi.org/10.1136/emj.2003.010421
- Spontaneous pneumothorax: is it under tension?.Emerg Med J. 2000; 17: 222-223
Article Info
Publication History
Published online: September 24, 2018
Accepted:
September 23,
2018
Received:
September 3,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
