Post-traumatic Pneumothorax.

A 24 years old male was brought to radiology department for X-ray chest following a road traffic accident. The X ray is shown below:

Radiological Findings: Chest X-ray shows presence of the air within the right pleural cavity with volume loss of right lung, as a result the right lung has partially collapsed. The outline of collapsed lung is seen well against the air.

Diagnosis: Post-traumatic Pneumothorax.

Clinical Discussion: Presence of the air within the pleural cavity is termed as the pneumothorax.
Air enters into the pleural cavity through the defect in pleural layers either spontaneously or due to trauma.


Spontaneous pneumothorax when seen in healthy individuals without any precipitating event is known as primary spontaneous pneumothorax in contrast to the secondary spontaneous pneumothorax which is seen in the setting of a predisposing lung disease like chronic obstructive pulmonary disease (COPD).

Traumatic pneumothorax is more common and is seen in patients undergoing mechanical ventilation. Traumatic pneumothorax also occurs due to blunt or penetrating chest trauma.

Clinical features: Patient with pneumothorax present with acute onset of sharp chest pain, dyspnea and cough. On examination there is asymmetric lung expansion, reduced breath sounds on affected side and hyperresonance on percussion.

Management varies from needle decompression to intercostal tube drainage and under water seal.