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Virtual Pediatric Hospital: Paediapaedia: Pneumothorax, Tension (PTX) Paediapaedia: Neonatal Chest Diseases

Pneumothorax, Tension (PTX)

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Clinical Presentation:
Neonate on a ventilator.

Etiology/Pathophysiology:
Caused by rupture of air at the root of the lung or from rupture of subpleural blebs due to increased over inflation of the lung from the ventilator. Air in the pleural space can lead to acute compromise of pulmonary ventilation and vascular perfusion (air block) which can lead rapidly to profound respiratory distress and vascular collapse. A tension pneumothorax is immediately life threatening, and must be treated immediately.

Pathology:
Not applicable.

Imaging Findings:
Flattening or inversion of the ipsilateral hemidiaphragm, shift of the mediastinal structures into the contralateral hemithorax by the large amount of air in the pleural space, compression atelectasis of the contralateral lung due to the mediastinal shift. icon gif

DDX:
Not applicable.

References:
See References Chapter.

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