CTICasesBuffalo Chest Physiology (Post-Bilateral Lung Transplant)
Imaging findings
Frontal chest radiograph in a patient shortly after bilateral lung transplantation demonstrates sizable bilateral pneumothoraces. Following the insertion of a single pleural chest tube on the left side, repeat radiographs demonstrate complete resolution of the pneumothoraces on both the left and right sides.
Key takeaways
Buffalo chest refers to an anatomical condition in which the pleural spaces communicate directly across the mediastinum, allowing air or fluid to flow freely between both hemithoraces. While normal in American bison, it is an acquired condition in humans following surgical procedures that breach the anterior mediastinum (such as a clamshell sternotomy or bilateral lung transplant), and it can be clinically managed with a single chest tube to evacuate bilateral pleural air or fluid.
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