case_images: PMC11084989_01
case_images: Chest x-ray showing the presence of bilateral tension pneumothorax.
case_images: 10.1177_29768675241249652-fig1.jpg
case_images: PMC11084989_01_10.1177_29768675241249652-fig1.jpg
case_images: fig1-29768675241249652
case_images: In imaging, chest x-ray shows bilateral tension pneumothorax with flattening of both diaphragmatic domes, reticular radiopacities, and mediastinal compression with a cardiac diameter of 11.1 and cardiothoracic index of 0.31 (Figure 1).
case_images: Chest computed tomography. (A) Coronal section displays bilateral pneumothorax and the presence of pleural adhesions. (B) Axial section:upper lobes, predominantly featuring thin-walled cavitary lesions and bronchiectasis. (C) Axial section:lower lobes, showing passive atelectasis and left pleural effusion.
case_images: 10.1177_29768675241249652-fig2.jpg
case_images: PMC11084989_01_10.1177_29768675241249652-fig2.jpg
case_images: fig2-29768675241249652
case_images: This condition is attributed to pleural adhesions extending from the visceral pleura to the parietal pleura, preventing total lung collapse (Figure 2A). Additionally, bronchiectasis, areas of consolidation, and zones of ground-glass opacity with a chronic appearance are observed (Figure 2B). In the lower lobes, there is evidence of passive atelectasis and a minimal left pleural effusion (Figure 2C).
case_images: Chest computed tomography (CT). It demonstrates partial expansion of both lungs, a right bronchopleural fistula, and bilateral hydropneumothorax with thoracic drainage tubes positioned in the lower lobes.
case_images: 10.1177_29768675241249652-fig3.jpg
case_images: PMC11084989_01_10.1177_29768675241249652-fig3.jpg
case_images: fig3-29768675241249652
case_images: However, on the tenth day of hospitalization, complications arose in the form of a third-degree bronchopleural fistula (according to the Cerfolio classification) and bilateral hydropneumothorax (Figure 3).
case_images: Heimlich valve placement.
case_images: 10.1177_29768675241249652-fig4.jpg
case_images: PMC11084989_01_10.1177_29768675241249652-fig4.jpg
case_images: fig4-29768675241249652
case_images: A Heimlich valve was placed in the right hemithorax (Figure 4).