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Emergency casebook
Localised pneumothorax
  1. A Vaghela1,
  2. M P G Morgan2
  1. 1Consultant in Accident and Emergency Medicine, Royal Gwent Hospital, Newport, UK
  2. 2Senior House Officer, Newport, UK
  1. Correspondence to:
 Matthew Morgan
 Accident and Emergency, Royal Gwent Hospital, Cardiff; mattmorgan{at}doctors.org.uk

https://doi.org/10.1136/emj.2006.036061

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    An 83-year-old man with known chronic obstructive airways disease presented to the accident and emergency department with increased shortness of breath. A portable AP chest radiograph showed a large localised pneumothorax of the right lower and mid-zones with areas of associated collapse. A chest drain was inserted and the patient subsequently improved. Localised pneumothoracies are rare and can often be missed on standard anterior posterior or posterior anterior radiographs if located posteriorly. Obstructive legions of the bronchi should be considered as a potential cause.

    Figure 1
    Figure 1

     Chest radiograph on admission.

    Figure 2
    Figure 2

     Chest radiograph post-pleural drainage.

    Footnotes

    • Competing interests: none declared