Bilateral pneumothoraces (capnothoraces)

Case contributed by Jayanth Keshavamurthy
Diagnosis almost certain

Presentation

History of ALS got immediate post-operative chest radiograph after bilateral diaphragmatic pacemakers.

Patient Data

Age: 45 years
Gender: Female

There are bilateral pneumothoraces in the apices. Given recent laparoscopy and diaphragmatic pacemakers, this was felt to be secondary to CO2 and capnothoraces. 

Annotated image

Bilateral pneumothorax. Diaphragmatic pacer wires are annotated.

Case Discussion

The patient was extubated without problems but had right-sided chest discomfort and therefore got a right pleural pigtail catheter 15 hours after this chest radiograph. The pneumothorax had not gotten bigger. The left apical pneumothorax resolved over 5 days.

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