CTICasesSpontaneous Pneumothorax with Reexpansion Edema (after scuba diving and flying)
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Imaging findings
An initial radiograph shows a large left pneumothorax with a bounded airspace at the left lung base. Post-catheter placement CT shows reexpansion edema, primarily in the left lung but also extending into the contralateral right lung, and a pre-existing lesion (likely a bleb or pneumatocele) at the lung base. The pigtail catheter appeared dislodged into the chest wall.
Key takeaways
Spontaneous pneumothorax can be triggered by rapid pressure changes, such as scuba diving (increased pressure forcing air into the lung) and flying (decreased atmospheric pressure causing pneumothorax to expand). Pre-existing blebs or cysts predispose to pneumothorax. Reexpansion edema can occur after lung reexpansion, even extending contralaterally, and is thought to involve a systemic cytokine release rather than purely hydrostatic forces. Future diving is contraindicated after spontaneous pneumothorax.
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