Images in emergency medicine
Article Outline
Diagnosis
Reexpansion pulmonary edema. The chest radiograph in Figure 3 shows reexpansion pulmonary edema, an uncommon complication of pneumothorax or pleural effusion treatment. The risk of reexpansion pulmonary edema is thought to be highest after rapid reexpansion of a lung that has been collapsed for more than 3 days.1, 2 Symptoms include mild to severe respiratory distress that typically begins within 5 hours after lung reexpansion.3 Treatment is supportive, with some patients requiring intubation or noninvasive positive airway pressure.4 Strategies to decrease the risk of reexpansion pulmonary edema include intermittent evacuation of a limited volume of air or fluid from the pleural space and the avoidance of continuous negative-pressure suction.1, 2
The patient’s pulmonary edema resolved during the following 8 days. Pleural fluid analysis led to the diagnosis of non-Hodgkin’s lymphoma. The patient’s fever was later attributed to pyelonephritis.
References
- Reexpansion pulmonary edema. Ann Thorac Surg. 1988;45:340–345
- Clinical analysis of reexpansion pulmonary edema. Chest. 1991;100:1562–1566
- . An uncommon life-threatening complication after chest tube drainage of pneumothorax ix the ED. Am J Emerg Med. 2004;22:615–619
- A case of unilateral re-expansion pulmonary oedema successfully treated with non-invasive continuous positive airway pressure. Eur J Emerg Med. 2004;11:291–294
PII: S0196-0644(06)00167-3
doi:10.1016/j.annemergmed.2006.01.040
© 2006 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
Refers to article:
- Images in emergency medicine , 14 March 2006
