Impact of pneumothorax-like pulmonary collapse caused by rapid bronchial obstruction: A case report of pneumothorax ex vacuo

Daisuke Hara; Ryoichi Kondo; Toshitaka Shomura; Toshihiko Agatsuma; Gaku Saito

doi:10.1016/j.rmcr.2023.101817

Impact of pneumothorax-like pulmonary collapse caused by rapid bronchial obstruction: A case report of pneumothorax ex vacuo

Respir Med Case Rep. 2023 Jan 25:42:101817. doi: 10.1016/j.rmcr.2023.101817. eCollection 2023.

Authors

Daisuke Hara^{1

2}, Ryoichi Kondo³, Toshitaka Shomura⁴, Toshihiko Agatsuma⁴, Gaku Saito¹

Affiliations

¹ Department of Thoracic Surgery, National Hospital Organization Shinshu Ueda Medical Center, Nagano, Japan.
² Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, Nagano, Japan.
³ Department of Thoracic Surgery, National Hospital Organization Matsumoto Medical Center, Nagano, Japan.
⁴ Department of Respiratory Medicine, National Hospital Organization Shinshu Ueda Medical Center, Nagano, Japan.

Abstract

We report two cases of pulmonary collapse that simulated pneumothorax on computed tomographic images and were caused by rapid complete bronchial obstruction. One patient was a 77-year-old woman with sudden dyspnea, and the other was an 83-year-old woman with sudden dyspnea who was infected with influenza A virus. Chest computed tomography revealed lobular complete atelectasis with an almost complete expansion of the other lobes of the right lung. Some air space in the right pleural cavity was also observed. Both cases were diagnosed as "pneumothorax" by primary doctors. We noted the disappearance of air density in the lumen of the right bronchus in both cases. We performed bronchoscopy before thoracic drainage and removed the obstruction. Immediately, the obstructed pulmonary lobes expanded, and the air space in the pleural cavity disappeared without thoracic drainage. In the literature, this pneumothorax-like pulmonary collapse is called as "pneumothorax ex vacuo."

Keywords: Bronchoscopy; PEV, pneumothorax ex vacuo; Pneumothorax ex vacuo; Pulmonary collapse.

Publication types

Case Reports