Article Text

Download PDFPDF
Tension pneumothorax and the “forbidden CXR”
  1. R McRoberts1,
  2. M McKechnie1,
  3. S Leigh-Smith2
  1. 1Emergency Department, The Royal Infirmary, Edinburgh, UK
  2. 2Defence Medical Services, Gosport, UK
  1. Correspondence to:
 Mr S Leigh-Smith
 c/o, Institute of Naval Medicine, Monckton House, Alverstoke, Gosport PO12 2DL, UK;


A case is presented of unilateral tension pneumothorax associated with flail chest and pulmonary contusions in a spontaneously ventilating patient after a fall. The tension element was not suspected until chest x ray was available, nor was immediate needle thoracocentesis performed. No morbidity resulted as a consequence. This case highlights the difficulty in deciding whether or not tension pneumothorax is the predominant cause of respiratory distress in a patient with multiple chest injuries. It provides further evidence challenging some of the doctrine on how to treat suspected tension pneumothorax.

  • CT, computed tomography
  • CXR, chest x ray
  • pneumothorax
  • tension

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding: none.

  • Competing interests: none declared