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Tension Pneumothorax and Re-Expansion Edema

Imaging findings

Chest radiograph shows a large left pneumothorax with mediastinal shift to the right, diaphragmatic inversion, and rib space widening, associated with severe hypotension. Post-drainage radiographs show rapid development of ipsilateral and mild contralateral pulmonary consolidation/edema.

Key takeaways

Tension pneumothorax is a clinical emergency defined by increased intrapleural pressure causing cardiovascular collapse. Rapid evacuation of the air can lead to re-expansion pulmonary edema, which is caused by capillary leakage and local cytokine release.

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