A strange case of a tension pneumothorax

Boon, D.; Llewellyn, T; Rushton, Prp

doi:10.1136/emj.19.5.470

Cited by 8 publications

(10 citation statements)

References 5 publications

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“…10 24 52 75 91 92 The most severe mediastinal displacement described was in a 5 year old boy, 53 which is in keeping with Rutherford's 30 comments (and chest radiographs showing) the mobility of the mediastinum in children and immature monkeys in contrast with the immobility in adults and goats. Children may therefore suffer more rapid TPT development because of the more mobile mediastinum.…”

Section: Mediastinal Deviationsupporting

confidence: 60%

Tension pneumothorax--time for a re-think?

Leigh-Smith

Harris

2004

Emergency Medicine Journal

283

230

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Section: Mediastinal Deviationsupporting

confidence: 60%

Tension pneumothorax--time for a re-think?

Leigh-Smith

Harris

2004

Emergency Medicine Journal

283

230

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“…Spontaneous PTX has been described in early infancy (3 week old girl) due a CPAM with atypical histologic features 3 . It has also been reported in other children beyond the neonatal period (ages 1.5 months to thirteen years old) and in these cases, was the initial presentation for their congenital lung disease 10, 11, 12, 13, 14, 15, 16, 17. Two similar cases have been described in 18 year olds, one patient who presented with hemoptysis and hemopneumothorax and another patient with pyopneumothorax, both who consequently underwent resection of a previously undiagnosed Type I CPAM 9, 19.…”

Section: Discussionmentioning

confidence: 94%

Spontaneous pneumothorax in a teenager with prior congenital pulmonary airway malformation

Shupe

Kwon

Morris

2014

Respiratory Medicine Case Reports

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Congenital pulmonary airway malformation (CPAM), previously referred to as congenital cystic adenomatoid malformation (CCAM), is a developmental malformation of the lower respiratory tract and the most commonly reported congenital lung lesion. Affected patients typically present with respiratory distress in the neonatal period from expanding cysts and resulting compression of surrounding lung parenchyma. However, some patients also remain asymptomatic until later in life. In this report, we present a case of CPAM requiring emergent left lower lobectomy at the first day of life that remained asymptomatic until the patient developed a spontaneous pneumothorax 18 years later. Our patient's presentation with an isolated spontaneous pneumothorax at age 18 does not appear to have been previously reported. In addition, there are several aspects of this case that represent atypical features of CPAM. After an extensive literature search, few reports exist describing any long-term complications of CPAM following neonatal lobectomy. Chest imaging in our patient demonstrated residual left basilar bullae and there was a moderate fixed obstructive/restrictive defect on pulmonary function testing. His risk for recurrent pneumothorax or infectious complications is unknown based on minimal published information on long-term outcomes or complications in patients with resected CPAM lesions. We conclude that follow up of all CPAM patients should include an evaluation for evidence of residual lung disease both with spirometric testing and chest imaging. Furthermore, concern for infectious complications or symptomatic obstructive lung disease should likewise be considered.

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“…Although prompt clinical diagnosis is essential, it should be noted that clinical signs of tension pneumothorax often are not very reliable (6,8,18). Cullinane et al found that in the pre-hospital setting, errors in clinical judgment led to a substantial number of unnecessary needle decompressions performed in the field (6).…”

Section: Discussionmentioning

confidence: 99%

“…However, the literature has numerous reports of the shortcomings or failure of this modality of treatment (1)(2)(3)(4)(5)(6). There are also at least three case reports describing patients with tension pneumothorax managed successfully by chest tube drainage, without performing immediate needle decompression (7)(8)(9). There seem to be certain clinical situations in which immediate chest tube drainage may be a better option than needle decompression for the management of tension pneumothorax.…”

Section: Introductionmentioning

confidence: 94%

Tension Pneumothorax Managed Without Immediate Needle Decompression

Chan

2009

The Journal of Emergency Medicine

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A strange case of a tension pneumothorax

Cited by 8 publications

References 5 publications

Tension pneumothorax--time for a re-think?

Tension pneumothorax--time for a re-think?

Spontaneous pneumothorax in a teenager with prior congenital pulmonary airway malformation

Tension Pneumothorax Managed Without Immediate Needle Decompression

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