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Background: Guidelines recommend prophylactic chest tube placement in patients with traumatic pneumothorax who require positive pressure ventilation to prevent tension pneumothorax. However, chest tube insertion is not without complications, and avoiding it when safely possible is desirable.
Case Presentation: A man in his 50 s with a left clavicle fracture and mild left-sided occult pneumothorax on computed tomography was scheduled for surgery under general anesthesia. Conservative management was chosen given the absence of respiratory symptoms and stable imaging. To minimize the risk of pneumothorax progression during positive pressure ventilation, one-lung ventilation was employed to avoid ventilating the affected lung. Surgery proceeded uneventfully, with transient hypoxemia that was managed by increasing FiO to 100%. Postoperative imaging confirmed re-expansion of the left lung and no pneumothorax progression. The patient was discharged in good condition.
Conclusions: General anesthesia was safely managed without prophylactic chest tube placement by employing one-lung ventilation in a patient with occult traumatic pneumothorax.
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http://dx.doi.org/10.1186/s40981-025-00812-w | DOI Listing |
Pediatr Pulmonol
September 2025
Department of Paediatric Respiratory Medicine, Staffordshire Children's Hospital at Royal Stoke, University Hospitals of North Midlands NHS Trust, Stoke on Trent, UK.
Pleural empyema is a recognized complication of pneumonia and causes significant morbidity in children. Insertion of a small-bore chest drain shortens hospital admission but can be associated with pneumothorax. This is usually assumed to be caused by a bronchopleural fistula or a displaced drain and therefore under pressure, requiring surgical intervention.
View Article and Find Full Text PDFJTCVS Open
August 2025
Department of Surgery, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY.
Objective: Persistent pulmonary air leak happens in a minority of patients with various thoracic pathologies. Spiration (Olympus America Inc.) bronchial valves (BVs) are approved by the Food and Drug Administration under Humanitarian Use Device status to treat persistent air leak after lung resection.
View Article and Find Full Text PDFCureus
August 2025
Respiratory Medicine, Dartford and Gravesham NHS Trust, Dartford, GBR.
Pressure-dependent pneumothorax is an under-recognized but clinically significant phenomenon that complicates pleural fluid drainage, particularly in patients with non-expandable lungs due to malignancy or chronic pleural fibrosis. Unlike pressure-independent pneumothorax, this condition arises from the pronounced transpleural pressure gradient generated during therapeutic thoracentesis or chest drainage. This negative pressure transiently distorts the visceral pleura, allowing air to enter the pleural space until an equilibrium is reached.
View Article and Find Full Text PDFMedicine (Baltimore)
September 2025
Department of Tuberculosis, Guiyang Public Health Clinical Center, Guiyang, Guizhou Province, China.
Rationale: We report an extremely rare case in which delayed diagnosis and treatment of Mycobacterium tuberculosis infection primarily involving the subcutaneous tissues of an extremity led to hematogenous dissemination of the infection and subsequent deterioration of the patient.
Patient Concerns: An 82-year-old man presented to our hospital with a painful mass on the right ankle for over a year, as well as persistent fever and shortness of breath for >14 days. He received piperacillin/tazobactam followed by meropenem, which failed to decrease his peak temperature.
J Telemed Telecare
September 2025
School of Medicine, The University of Queensland, St Lucia, QLD, Australia.
In this case, we describe the remote telehealth leadership of emergent tube thoracostomy in a patient with a critical respiratory status. The patient had presented to a small rural health care facility with breathlessness and hypoxia despite supplemental oxygen. A subsequent chest x-ray revealed a large pneumothorax requiring emergent treatment to prevent respiratory demise.
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