CTICasesPneumothorax ex Vacuo
Imaging findings
Sequential bedside radiographs in a trauma patient demonstrate acute-onset right upper lobe atelectasis with an elevated minor fissure, accompanied by a localized, small pneumothorax immediately adjacent to the collapsed lobe, despite an in-place pleural drainage tube.
Key takeaways
Pneumothorax ex vacuo occurs when rapid lobar collapse (atelectasis) creates a sharp increase in negative intrapleural pressure, drawing gas (likely nitrogen) into the localized pleural space adjacent to the collapsed lung. This type of pneumothorax is transient, benign, and does not require additional chest tube placement, as it resolves once the underlying atelectasis is corrected.
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