CTICasesIatrogenic Tension Pneumothorax due to Malpositioned Heimlich Valve
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Imaging findings
Initially, a pneumothorax is present. Following placement of a Heimlich valve, the lung collapses further, and a large, progressive pneumothorax develops. After the valve is adjusted, the lung re-expands and the pneumothorax resolves.
Key takeaways
A Heimlich valve is designed as a one-way valve to allow air to exit the pleural space but prevent its re-entry. If the valve is inadvertently hooked up backward, it will allow air to enter the pleural space but not escape, leading to a progressive and potentially life-threatening tension pneumothorax. This case highlights the critical importance of correct valve orientation during placement.
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