Pneumothorax Ex Vacuo: A Rare Complication of PleurX Catheter Insertion

Pneumothorax ex vacuo (PEV) is a rare type of pneumothorax that occurs when air enters the pleural space in the chest cavity due to an increase in the volume of the lungs or a reduction in the volume of the surrounding lung tissue. Unlike a typical pneumothorax, which involves the collapse of the lung due to air accumulation, pneumothorax ex vacuo occurs when the lung itself cannot expand properly, often due to underlying lung disease or conditions such as pulmonary fibrosis or atelectasis. The mechanism is compensatory to the lung entrapment. PleurX catheter (Pleur-Evac; Teleflex, Wayne, PA, USA) insertion can cause pneumothorax ex vacuo in patients with cancer histories, as shown in this case. It is important to understand if pneumothorax ex vacuo needs observation or quick intervention. Pleural manometry is also an important part of diagnosis of pneumothorax ex vacuo and we discuss that in our case report.