Pneumothorax, which was not a pneumothorax

Czech version

Authors: V. Matoušek ^1,3; P. Zemanová ²; Z. Stach ¹
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny, 1. lékařská fakulta Univerzity Karlovy, a Všeobecná fakultní nemocnice v Praze ¹; I. klinika tuberkulózy a respiračních nemocí, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice v Praze ²; Klinika anesteziologie, perioperační a intenzivní medicíny, Univerzita J. E. Purkyně v Ústí nad Labem, Masarykova nemocnice v Ústí nad Labem ³
Published in: Anest. intenziv. Med., 32, 2021, č. 1, s. 48-51
Category: Case Reports

Overview

66 y.o. patient with end-stage chronic obstructive pulmonary disease was hospitalized in a standard ward, after abrupt onset of dyspnea a chest X-ray showed a pneumothorax. However, ultrasound examination before pleural drainage did not confirm pneumothorax and thus drainage was not performed. A computed tomography scan showed vanishing lung syndrome, explaining the X-ray finding. This case report points out vanishing lung syndrome and demonstrates complementarity of different imaging methods in diagnostic of pneumothorax in patient with complicated intrathoracic pathologies.

Keywords:

pneumothorax – ultrasound – computed tomography – chronic obstructive pulmonary disease – vanishing lung

Sources

1. Škulec R, Pařízek T, Pakostová B, Bílská M, Černý V. Kritické hodnocení ultrasonografické diagnostiky pneumotoraxu. Urgentní medicína 2020; 3: 11–17.

2. Desai P, Steiner R. Images in COPD: Giant Bullous Emphysema. Chronic obstructive pulmonary diseases 2016; 3(3): 698–701. doi: 10.15326/jcopdf.3. 3. 2016.0154.

3. Burke RM. Vanishing lungs: a case report of bullous emphysema. Radiology 1937; 28(3): 367–371. doi: http://dx.doi.org/10.1148/28. 3. 367.

4. Im Y, Farooqi S, Mora A Jr. Vanishing lung syndrome. Proc (Bayl Univ Med Cent). 2016; 29(4): 399–401. doi: 10.1080/08998280.2016.11929486.

5. Ferreira Junior EG, Costa PA, Silveira L, Almeida L, Sylviini N, Loureiro BM. Giant bullous emphysema mistaken for traumatic pneumothorax. International journal of surgery case reports 2019; 56: 50–54. doi: 10.1016/j.ijscr.2019. 02. 005.

6. Sharma N, Justaniah AM, Kanne JP, Gurney JW, Mohammed TL. Vanishing lung syndrome (giant bullous emphysema): CT findings in 7 patients and a literature review. J Thorac Imaging. 2009 Aug; 24(3): 227–230. doi: 10.1097/RTI.0b013e31819b9f2a. Review. Pub- Med PMID: 19704328.

7. Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW, et al. International evidence‑based recommendations for point‑of‑ care lung ultrasound. Intensive Care Med 2012; 38: 577. https://doi.org/10.1007/s00134-012-2513-4

8. Lichtenstein DA, Menu Y. A bedside ultrasound sign ruling out pneumothorax in the critically ill. Lung sliding. Chest, 1995 Nov; 108(5): 1345–1348. doi: 10.1378/chest.108. 5. 1345. PMID: 7587439

9. Gelabert C, Nelson M. Bleb point: mimicker of pneumothorax in bullous lung disease. West J Emerg Med. 2015; 16(3): 447–449. doi: 10.5811/westjem.2015. 3. 24809