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Christian Lund Petersen1,2, Leo Nygaard2

  • 1Røntgenafdelingen, Syddansk Universitetshospital - Sygehus Lillebælt, Vejle Sygehus.

Ugeskrift for Laeger
|July 2, 2024
PubMed
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Contralateral pneumothorax is a rare injury in unilateral trauma. This case highlights the importance of examining both sides of the chest after significant chest trauma.

Area of Science:

  • Trauma surgery
  • Thoracic surgery
  • Emergency medicine

Background:

  • Unilateral chest trauma can lead to complex injuries.
  • Contralateral pneumothorax is an uncommon complication, particularly without direct chest wall injury on the affected side.

Observation:

  • A 19-year-old woman sustained high-energy left-sided trauma with multiple left rib fractures (8-12).
  • Despite left-sided injuries, a large right-sided pneumothorax was identified, with no left pneumothorax.
  • No fractures were noted on the right side of the chest.

Findings:

  • The case presents an extremely rare instance of contralateral pneumothorax following primarily unilateral chest trauma.
  • A potential mechanism proposed is barotrauma resulting from increased intrathoracic pressure and external compression.

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Implications:

  • This case underscores the necessity for thorough bilateral physical examination in patients with unilateral chest trauma.
  • Clinicians must consider the possibility of contralateral injuries, even in the absence of ipsilateral chest wall fractures.
  • Prompt recognition and management of contralateral injuries are crucial to prevent severe morbidity.