Faces of Pneumothorax

Parts
Size Small



CXR Spontaneous Pneumothorax
20-year-old female presents with acute left sided chest pain. She has a narrow A-P diameter exemplified in the lateral projection (below) and the asthenic build raises the suspicion for spontaneous pneumothorax. Frontal CXR shows a small subtle pneumothorax characterised by a thin pleural line and relative lucency of the left apex compared to the right
Ashley Davidoff MD TheCommonVein.net 117246c

 

 

CXR Spontaneous Pneumothorax
20-year-old female presents with acute left sided chest pain. She has asthenic build which raises the suspicion for a spontaneous pneumothorax. Frontal CXR shows a small subtle pneumothorax characterised by a thin pleural line (b, white arrowhead) and relative lucency of the left apex
Ashley Davidoff MD TheCommonVein.net 117246c01

Deep Sulcus Sign – Semi-Erect 

Deep Sulcus Sign
51 year old male with recent trauma with multiple rib fractures on the left resulting in flail chest. Rib fixation hardware is present on the left. Fractures are also presnt on the right and there are bilaterl chest tubes.
A subpulmonic pneumothoraxis present
Ashley Davidoff TheCommonVein.net 136507
Deep Sulcus Sign
51 year old male with recent trauma with multiple rib fractures on the left resulting in flail chest. Rib fixation hardware is present on the left. Fractures are also present on the right and there are bilateral chest tubes.
A subpulmonic pneumothorax is present with the displaced pleura noted (b, white arrowheads) and the basal pneumothorax (b blue arrowhead). Note the patient is in the semi-upright position and likely more supine than upright based on the position of the pneumothorax
Ashley Davidoff TheCommonVein.net 136507cL

Tension Pneumothorax with Shift of the Heart to the Left

Post Endoscopy Pneumothorax with Shift of the Heart to the Left
? Tension Pneumothorax
Ashley Davidoff MD TheCommonVein.net
Post Endoscopy Pneumothorax with Shift of the Heart to the Left
? Tension Pneumothorax
Ashley Davidoff MD TheCommonVein.net

Tension Pneumothorax  and the Mediastinum

Tension Pneumothorax                                                                                                                                                     In the upper images the forces of the mediastinum overcome the forces of the lung which are at low pressure. In tension pneumothorax the pressures in this case, in the left thorax,  keep on increasing as more air builds up,  and eventually exceed the forces of the mediastinum The mediastinum gets compressed,  preventing blood return and resulting in poor cardiac output            Ashley Davidoff MD TheCommonVein.net 42106c04

Shape

SLE PE Bronchopleural Fistula and Loculated Pneumothorax

SLE PE Bronchopleural Fistula and Loculated Pneumothorax
24 year old male with SLE presented with chest pain and dyspnea and initial CT showed occlusive pulmonary emboli to the right lower lobe initially associated with a wedge shaped ground glass region. 2 weeks later this evolved into a bronchopleural fistula, with a loculated pneumothorax in the right lower lobe (green star in a,b,c,d).with an air fluid level (yellow arrowhead in a,c,d) and a region of compressive atelectasis (white arrowhead a,c,d).
Ashley Davidoff MD TheCommonVein.net 130726


Position
Character
Time

Associated Findings

Tension Pneumothorax
Venous Reflux and
Benign Pneumatosis Coli

Tension Pneumothorax Venous Reflux and Benign Pneumatosis Coli
65 year old male s/p MVA presents in shock. Scout film (top left) shows left sided tension pneumothorax with rightward mediastinal shift. Axial CT through the liver (top right) shows expanded pneumothorax at the left lung base with reflux of contrast into the IVC.. Contrast also refluxes into the right renal vein (bottom left) and into the internal iliac veins (bottom right) Associated pneumatosis intestinalis in the sigmoid colon is present as well and likely secondary to the tension pneumothorax
Ashley Davidoff MD TheCommonVein.net 24153c

Post Cryoablation with Contusion and Pneumothorax

Post Cryoablation with Contusion and Pneumothorax
Following  biopsy and cryoablation a contusion is noted in the lung associated with a small pneumothorax
Biopsy of the lung confirmed  the presence of a squamous cell carcinoma.
Ashley Davidoff MD TheCommonVein.net

Infection

Pneumocystis Carinii Pneumonia and Pneumothorax

Pneumocystis carinii pneumonia. CT scans in a 32-year-old man with acquired immunodeficiency syndrome and a CD4 count of 7cells per microliter who presented with respiratory arrest. (a) Axial and (b) coronal images in lung windows demonstrate a moderate right pneumothorax (*) and widespread ground-glass and airspace opacities.
Parekh, M et al Review of the Chest CT Differential Diagnosis of Ground-Glass Opacities in the COVID Era Radiology Vol. 297, No. 3 July 2020

Inflammation

Malignancy

Mechanical

Atelectasis

Trauma

Metabolic

Circulatory- Hemorrhage

Catamenial Pneumothorax and Recurrent Hemothorax 

Catamenial Pneumothorax and Recurrent Hemothorax and  and Hemoperitoneum 
30 year old female presented in 2013 with acute pneumothorax with tamponade requiring placement of a chest tube
Ashley Davidoff TheCommonVein.net 130915.8

SLE PE Bronchopleural Fistula and Loculated Pneumothorax

SLE PE Bronchopleural Fistula and Loculated Pneumothorax
24 year old male with SLE presented with chest pain and dyspnea and initial CT showed occlusive pulmonary emboli to the right lower lobe initially associated with a wedge shaped ground glass region. 2 weeks later this evolved into a bronchopleural fistula, with a loculated pneumothorax in the right lower lobe (green star in a,b,c,d).with an air fluid level (yellow arrowhead in a,c,d) and a region of compressive atelectasis (white arrowhead a,c,d).
Ashley Davidoff MD TheCommonVein.net 130726

Immune Infiltrative Idiopathic Iatrogenic