Tuberc Respir Dis.  2009 Jul;67(1):59-62.

A Case of Focal Reexpansion Pulmonary Edema after Chest Tube Insertion

• Chung HK
• Jang WH
• Kim YK
• Lee YM
• Hwang JH
• Kim KU
• Uh ST

Abstract

Reexpansion pulmonary edema is not a common phenomenon after chest tube insertion but some reports from 0% to 14%. There are various resulting complications, including acute respiratory distress syndrome. We report a case of focal reexpansion pulmonary edema after chest tube insertion. A 49-year-old male came to the hospital due to ongoing dyspnea and left chest pain for 3 days. On chest X-ray, the patient had a left pneumothrax. We planned to insert a chest tube for symptom relief. To determine whether or not the chest had expanded as a result of the chest tube insertion, the patient underwent repeated chest X-rays the following day. The patient experienced brief respiratory symptoms upon initial suction; a chest PA showed patchy consolidated infiltration at the inserted site. After 5 days of conservative management, the recovered completely.

Keyword

Reexpansion pulmonary edema; Pneumothorax; Chest tube insertion

MeSH Terms

Chest Pain
Chest Tubes
Dyspnea
Humans
Male
Middle Aged
Pneumothorax
Porphyrins
Pulmonary Edema
Respiratory Distress Syndrome, Adult
Thorax
Porphyrins

Figure

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  Figure 1 Chest PA and left lateral from 49-year-old male, who had chest pain and dyspnea during three days, showed left pneumothorax. The patient had been shown total collapsed at the area of lower lung (arrow) with small amount of pleural effusion but upper area had been spared due to adhesion by old tuberculous scar.

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  Figure 2 The next day after chest tube insertion, chest PA showed infiltration and consolidation at the left lower lung field. Lateral film revealed loss of diaphragm shadow and prominent consolidation at the posterior basal area.

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  Figure 3 Computerd tomography were checked immediately after detection of consolidation by chest radiography. At the upper level of totally collapsed area, parenchymal infiltrations were scattered from dependent area to lingular segment (A, B). The bottom level, patchy consolidation were detected almost all at the dependent area (C, D). Their differences of consolidation between upper and lower level were seems to reexpansion pressure from negative suction chamber.

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  Figure 4 Chest PA and left lateral after removal of chest tube after 5 day the lesion, which had been occupied consolidation at posterobasal area, were resolved completely.

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