Abstract
We report a case of 46-year-old male with simultaneous bilateral spontaneous tension pneumothorax. Severe reexpansion pulmonary edema developed after bilateral tube thoracoscomy, but he was recovered after 2 days ventilator care. After bilateral wedge resection and talc pleurodesis, he was discharged without complications and had remained well and without recurrence during the 8-year follow-up.
Highlights
Unilateral spontaneous pneumothorax is a common clinical problems, but simultaneous bilateral spontaneous pneumothorax is rare and can be fatal if it progress to tension pneumothorax [1]
We present a case of reexpansion pulmonary edema followed by simultaneous bilateral spontaneous pneumothorax
Immediate chest x-ray could confirm the existence of tension pneumothorax, the deteriorated condition of patients with simultaneous bilateral tension pneumothorax requires emergent endotracheal intubation and positive airway pressure ventilation aggravates the tension pneumothorax
Summary
Unilateral spontaneous pneumothorax is a common clinical problems, but simultaneous bilateral spontaneous pneumothorax is rare and can be fatal if it progress to tension pneumothorax [1]. Life-threatening presentation of simultaneous bilateral spontaneous tension pneumothorax is extremely rare. We present a case of reexpansion pulmonary edema followed by simultaneous bilateral spontaneous pneumothorax. On arrival the patient was awake, his initial blood pressure was 240/150 mmHg, and respiratory rate was 38 breaths/ min. Despite oxygen supplementation, his oxygen saturation dropped to 80% and he became cyanotic, suffered a seizure, and had no detectable pulse. Endotracheal intubation was performed immediately, followed by a chest radiograph, which showed bilateral tension pneumothorax (Figure 1). A subsequent chest radiograph revealed that both lungs were fully
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