CTICasesBuffalo Chest (Bilateral Pneumothoraces with Pleural Communication)
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Imaging findings
A bilateral lung transplant patient presented with a little air outside her left chest wall and lucency at both lung bases, with clear pleural lines indicating bilateral pneumothoraces. A CT confirmed bilateral pneumothoraces and demonstrated dehiscence at her clamshell thoracotomy site, with air tracking into the chest wall, showing communication between the pleural spaces.
Key takeaways
A 'buffalo chest' refers to the communication between the two pleural spaces, typically following major thoracic surgery like bilateral lung transplant. This allows for bilateral pneumothoraces, which can appear spontaneously and resolve, even when asymptomatic. It's an important consideration when bilateral pneumothoraces are observed in post-surgical patients.
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