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An unusual phenomenon following simple aspiration of pneumothorax
- Daniel K C Lee (20 November 2007)
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Daniel K C Lee, MB, BCh, MRCP, MD Department of Respiratory Medicine, Norfolk and Norwich University Hospital, Norwich, United Kingdom
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dkclee{at}doctors.org.uk Daniel K C Lee
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A 62-year-old gentleman presented with a 10-day history of right sided pleuritic chest pain and shortness of breath. Chest X-ray (CXR) on admission (left) confirmed a primary spontaneous pneumothorax of the right lung. This was treated with simple needle aspiration. CXR immediately after the procedure (middle) showed re-expansion of the right lung with unilateral pulmonary oedema. Subsequent CXR (right) demonstrated complete resolution of both the pneumothorax and re-expansion pulmonary oedema (REPO). REPO is an extremely uncommon but recognised complication of re-expansion of the lung following evacuation of either air or fluid from the pleural space. REPO has an overall incidence of 1% and its occurrence after simple needle aspiration of pneumothorax is exceptionally rare. Despite treatment which involves resuscitation with intravenous fluid and oxygen therapy, REPO is potentially fatal with mortality as high as 20%. |
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