Pneumothorax ex vacuo (PEV) is a rare type of pneumothorax that occurs when air enters the pleural space in the chest cavity due to an increase in the volume of the lungs or a reduction in the volume of the surrounding lung tissue. Unlike a typical pneumothorax, which involves the collapse of the lung due to air accumulation, pneumothorax ex vacuo occurs when the lung itself cannot expand properly, often due to underlying lung disease or conditions such as pulmonary fibrosis or atelectasis. The mechanism is compensatory to the lung entrapment. PleurX catheter (Pleur-Evac; Teleflex, Wayne, PA, USA) insertion can cause pneumothorax ex vacuo in patients with cancer histories, as shown in this case. It is important to understand if pneumothorax ex vacuo needs observation or quick intervention. Pleural manometry is also an important part of diagnosis of pneumothorax ex vacuo and we discuss that in our case report.
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http://dx.doi.org/10.7759/cureus.41882 | DOI Listing |
Respir Med
April 2024
Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Background: Medical Thoracoscopy (MT) is a diagnostic procedure during which after accessing the pleural space the patient's negative-pressure inspiratory efforts draw atmospheric air into the pleural cavity, which creates a space to work in. At the end of the procedure this air must be evacuated via a chest tube, which is typically removed in the post-anesthesia care unit (PACU). We hypothesized that its removal intra-operatively is safe and may lead to lesser post-operative pain in comparison to its removal in the PACU.
View Article and Find Full Text PDFBMC Pulm Med
November 2023
Department of Respiratory Diseases Ibn Rochd Casablanca, Casablanca, Morocco.
This case presents a rare occurrence of re-expansion pulmonary edema following a drainage of pyo-pneumothorax in a 33-year-old patient. The diagnosis was established through a thoracic radiography, and the treatment consisted of symptomatic management, showing positive progress. Later on, the patient was diagnosed with pleural tuberculosis via GeneXpert testing and subsequently initiated on anti-bacterial therapy.
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October 2023
Research, Northeast Georgia Medical Center Gainsville, Georgia, USA.
Pneumothorax ex vacuo and trapped lung represent challenging clinical entities, especially in the context of pre-existing comorbidities. This case report outlines the diagnostic and management pathway of a 38-year-old patient with cerebral palsy who initially presented with empyema. Following the evacuation of the empyema, the patient developed pneumothorax ex vacuo, a rare phenomenon occurring due to a vacuum-like negative intrapleural pressure initiated by lung collapse.
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July 2023
Pulmonary and Critical Care, Howard University Hospital, Washington DC, USA.
Pneumothorax ex vacuo (PEV) is a rare type of pneumothorax that occurs when air enters the pleural space in the chest cavity due to an increase in the volume of the lungs or a reduction in the volume of the surrounding lung tissue. Unlike a typical pneumothorax, which involves the collapse of the lung due to air accumulation, pneumothorax ex vacuo occurs when the lung itself cannot expand properly, often due to underlying lung disease or conditions such as pulmonary fibrosis or atelectasis. The mechanism is compensatory to the lung entrapment.
View Article and Find Full Text PDFCureus
July 2023
Respiratory Medicine, Queen Elizabeth Hospital Gateshead, Newcastle Upon Tyne, GBR.
Non-expandable lungs are usually diagnosed after a pleural intervention. It can be challenging to differentiate between an iatrogenic pneumothorax and a new diagnosis of non-expandable lungs following a pleural intervention. The correct assessment can save the patient from undergoing the insertion of an unnecessary intercostal chest drain, which often leads to catastrophe.
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