title: A spontaneous pneumothorax in a "buffalo chest".
abstract: Spontaneous contralateral pneumothorax after pneumonectomy is a rare condition. A high index of suspicion is required for a correct diagnosis. Management can be challenging, as surgical intervention, if necessary, is a very high risk procedure. Chemical pleurodesis can be a simple and effective measure in cases with no major air leak. We describe the case of a 21-year-old female with spontaneous pneumothorax in a single lung, which posed several diagnostic and therapeutic problems. The presence of a "buffalo chest" made the initial chest x-ray interpretation difficult. The patient had an important air leak without complete pulmonary expansion and thoracic surgery was considered of risk. Accordingly, instillation of talc slurry through one of the thoracic drains was undertaken with eventual resolution. We are convinced that bronchopleural fistula resolution was facilitated by slurry talc, despite complete lung expansion never having been achieved.
authors: Interna Complementar de Pneumologia do Hospital de S. João, 4202-451 Porto, Portugal. a.n.marinho@tvtel.pt
authors: Anabela
authors: A
authors: Marinho
authors: Beatriz
authors: B
authors: Lima
authors: Idalina
authors: I
authors: Araújo
authors: Pedro
authors: P
authors: Bastos
authors: J Agostinho
authors: JA
authors: Marques
authors: Isabel
authors: I
authors: Gomes
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D011013:Pneumonectomy; D011030:Pneumothorax / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy