When is a pneumothorax not a pneumothorax?

Harte, Sinead; Casey, Rowan G.; Mannion, Des; Corbally, Martin

doi:10.1016/j.jpedsurg.2004.11.019

Cited by 9 publications

(5 citation statements)

References 4 publications

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“…Several conditions have been reported to potentially give the false appearance of a pneumothorax on plain chest radiographs, and these have been collectively referred to as "pseudo-pneumothorax". They include skin folds, bed sheet folds, clothes, pleural cysts, medial border of the scapula, and the elevated hemidiaphragm [3][4][5][6]. A skin fold in the chest wall can resemble pneumothorax by producing a curvilinear shadow over the lung that is similar to the visceral pleural line produced by pneumothorax when air accumulates inside the pleural space separating the visceral from the parietal pleura.…”

Section: Discussionmentioning

confidence: 99%

Pseudo-Pneumothorax Due to Skin Folds in a Patient With Pneumonia

Jalamneh¹,

Taher²,

Nassar³

et al. 2023

Cureus

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Pseudo-pneumothorax refers to several conditions that can mimic pneumothorax on chest radiography, leading to diagnostic uncertainty and unnecessary interventions. These include skin folds, bed sheet folds, clothes, scapular borders, pleural cysts, and elevated hemidiaphragm. We report a case of a 64-year-old patient with pneumonia whose chest radiograph revealed, in addition to the typical pneumonia findings, what appeared similar to bilateral pleural lines raising the suspicion of bilateral pneumothorax, but this finding was not supported clinically. Careful reexamination and further imaging ruled out the possibility of pneumothorax and concluded that this was the result of artifacts produced by skin folds. The patient was admitted and received intravenous antibiotics and was discharged three days later in stable condition. Our case highlights the importance of careful examination of imaging findings before unnecessarily proceeding to tube thoracostomy, especially when the clinical suspicion of pneumothorax is low.

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Section: Discussionmentioning

confidence: 99%

Pseudo-Pneumothorax Due to Skin Folds in a Patient With Pneumonia

Jalamneh¹,

Taher²,

Nassar³

et al. 2023

Cureus

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“…It commonly presents during the surgery itself or in the immediate post-operative period and is treated with the placement of an ICC [ [7] , [8] ]. A paraoesophageal hernia mimicking a pneumothorax or tension pneumothorax in the adult is a rare phenomenon and only a few cases have been cited in the literature [ [9] , [10] , [11] , [12] , [13] ]. There are a number cases where patients with large paraoesophageal hernias present with respiratory distress and haemodynamic instability, but the initial chest x-ray has shown signs of the large paraoesophageal hernia (e.g.…”

Section: Discussionmentioning

confidence: 99%

Gastrothorax: A case of mistaken identity

Wickramasinghe

Ruggiero

Low

2018

International Journal of Surgery Case Reports

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HighlightsPatients with a recent history of anti-reflux surgery, who present with a tension pneumothorax could be presenting with a gastrothorax.They should always be treated with an intercostal catheter if they are in respiratory distress.Follow up imaging with a CT scan is needed to confirm diagnosis.Gastrothorax should be urgently managed with the insertion of a nasogastric tube and surgical decompression.Good control of post- operative nausea and vomiting is essential in avoiding wrap failure and ensuing complications.

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“…Chaudhary et al 6 found that the findings strongly suggestive of diaphragmatic rupture include an abnormal, usually high diaphragmatic contour with an arch-like shadow that simulates the diaphragm, gas bubbles or air-fluid levels in the chest above the expected levels of the diaphragm, intrathoracic abdominal viscera, with or without a site of focal constriction (collar sign) and clear demonstration of the nasogastric tube tip above the left hemidiaphragm.…”

Section: Discussionmentioning

confidence: 99%

Diaphragmatic hernia mimicking hydropneumothorax: common error in emergency department

et al. 2013

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Detection of diaphragmatic hernia in the acute setting is problematic and diagnosing diaphragmatic hernia as hydropneumothorax is not an uncommon mistake. We present a series of four such cases diagnosed over a 7-year period, from December 2004 to January 2011 and analyse them for how this mistake can be avoided. In case of all the patients reported by us the initial radiographs were technically compromised because the patient could not be positioned properly. Also they were examined by non-radiologists. We feel that treating surgeons in emergency department tend to overdiagnose pneumothorax as it is a life-threatening condition. We feel that in the appropriate setting suspicion of diaphragmatic hernia should be raised in patients having fractured ribs associated with homogenous opacity, which cannot be differentiated from the diaphragm. Evidence of loculation of hydropneumothorax in the appropriate setting should also raise the possibility of diaphragmatic hernia.

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When is a pneumothorax not a pneumothorax?

Cited by 9 publications

References 4 publications

Pseudo-Pneumothorax Due to Skin Folds in a Patient With Pneumonia

Pseudo-Pneumothorax Due to Skin Folds in a Patient With Pneumonia

Gastrothorax: A case of mistaken identity

Diaphragmatic hernia mimicking hydropneumothorax: common error in emergency department

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