Medical image of the week: bilateral pneumothorax, pneumomediastinum, and massive subcutaneous emphysema

Southwest Journal of Pulmonary and Critical Care. 2014;8(3):181-182 DOI 10.13175/swjpcc020-14


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Journal Title: Southwest Journal of Pulmonary and Critical Care

ISSN: 2160-6773 (Online)

Publisher: Arizona Thoracic Society

LCC Subject Category: Medicine: Medicine (General): General works | Medicine: Internal medicine: Medical emergencies. Critical care. Intensive care. First aid

Country of publisher: United States

Language of fulltext: English

Full-text formats available: PDF, HTML



Ahmed Z (Icahn School of Medicine at Mount Sinai, Queenz, NY)
Singh M (Icahn School of Medicine at Mount Sinai, Queenz, NY)
Lopez R (Icahn School of Medicine at Mount Sinai, Queenz, NY)


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Time From Submission to Publication: 1 weeks


Abstract Full Text

No abstract available. Article truncated at 150 words. An 80 year old man with chronic obstructive pulmonary disease (COPD) presented to the emergency department with respiratory distress and poor oxygen saturation. Physical exam revealed an obese male in respiratory distress with poor air entry bilaterally and scattered wheezing. His chest, neck, tongue, and lips were swollen. The patient was intubated for respiratory failure, felt to be due to angioedema. His oxygen saturation immediately improved, however the patient developed progressive swelling throughout his body including his eyelids, fingers and toes. Diffuse crepitus was felt on palpation. Chest radiography and computed tomography (CT) of the chest revealed large bilateral pneumothoraces, pneumomediastinum, and subcutaneous emphysema (Figure 1). Bilateral chest tubes were inserted with re-expansion of both lungs. Over the next several days his respiratory parameters improved, with full re-expansion of the lungs and reabsorption of the pneumomediastinum and subcutaneous emphysema. The patient was extubated successfully and was discharged in good health. ...