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Related Experiment Videos

Pneumothorax necessitans presenting as a presternal pneumothoracocele.

S P Tripathi1, M G Massad, V K Mehta

  • 1Department of Surgery, The University of Illinois at Chicago, 60612, USA.

The Annals of Thoracic Surgery
|February 2, 2000
PubMed
Summary

Intravenous drug abuse can lead to sternoclavicular joint infection and chest wall abscesses. A rare complication, "pneumothorax necessitans," presents as an anterior chest mass and should be considered in differential diagnoses.

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Area of Science:

  • Infectious Diseases
  • Thoracic Surgery
  • Radiology

Background:

  • Sternoclavicular joint infections are serious, often stemming from intravenous drug use.
  • Osteomyelitis can lead to significant tissue destruction and abscess formation.
  • Pneumothorax, the presence of air in the pleural space, can have varied presentations.

Observation:

  • A case of sternoclavicular joint infection in an intravenous drug abuser is presented.
  • The infection eroded the manubrium, causing mediastinal and subcutaneous abscesses.
  • A subsequent apical pneumothorax led to air entrapment, forming an anterior "pneumothoracocele."

Findings:

  • The condition was termed "pneumothorax necessitans" due to the specific mechanism of air entrapment.
  • This presentation mimicked an anterior chest wall mass.

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  • The erosion through the manubrium facilitated the communication between infection and air entrapment.

    • Implications:

    • "Pneumothorax necessitans" should be included in the differential diagnosis of anterior chest wall masses.
    • Early recognition is crucial for appropriate management of complex infections and thoracic complications.
    • This case highlights the diverse and severe complications associated with intravenous drug abuse.