Abstract
Spontaneous pneumothorax is a frequent situation in respiratory medicine, and its treatment is based on conservative treatment or pleural drainage. Reexpansion pulmonary edema (REPE) is often a mild complication following pneumothorax drainage. We report here a severe case of unilateral REPE following spontaneous pneumothorax drainage associated with major pulmonary plasmatic leakage. The clinical presentation was severe and sudden with respiratory and circulatory failures. Initial resuscitation was mostly based on prone and head-down positioning in association to fluid expansion and mechanical ventilation. On the basis of this clinical case report, we strongly suggest to think about severe pulmonary reexpansion edema when respiratory and hemodynamic failures occur few hours after pneumothorax-related efficient pleural tube drainage.
Highlights
Spontaneous pneumothorax treatment is a common pathology in respiratory medicine
The incidence of mild reexpansion pulmonary edema (REPE) seems to vary between 0.9% and nearly 75% of patients treated for spontaneous pneumothorax
The patient’s drug consumption was stopped for more than one year yet, and if such background could have increased the risk of pneumothorax, we do suggest that it could not stand in this case as a relevant differential diagnosis from REPE
Summary
Spontaneous pneumothorax treatment is a common pathology in respiratory medicine. Severe reexpansion pulmonary edema (REPE) is a rare complication of pneumothorax treatment. The incidence of mild REPE seems to vary between 0.9% and nearly 75% of patients treated for spontaneous pneumothorax [1] This variation is mostly a consequence of various diagnostic criteria or radiologic procedures. Most clinical presentations of REPE are mild, and treatment is mostly symptomatic even if some authors have used steroids [2]
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