CTICasesPneumothorax ex vacuo following endobronchial valve placement
Imaging findings
Chest radiographs and CT scan show placement of three endobronchial valves in the left upper lobe, resulting in complete left upper lobe atelectasis. There is an associated left-sided pneumothorax (pleural gas with a fluid level) representing a pneumothorax ex vacuo.
Key takeaways
Pneumothorax ex vacuo can occur following rapid lobar collapse (e.g., after endobronchial valve placement for lung volume reduction). It represents nitrogen accumulation in the pleural space due to acute volume loss rather than a visceral pleural leak, and should generally be managed conservatively without a chest tube.
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