PMC5910498_01
Large right sided pneumothorax at presentation.
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Arterial blood gas on admission demonstrated hypoxia with decompensated respiratory acidosis and chest X-ray showed a large right-sided pneumothorax (Fig. 1).
a) Developing subcutaneous emphysema post ICC insertion. b) Severe, extensive subcutaneous emphysema causing palpebral closure and facial swelling.
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The intercostal catheter was repositioned and high wall suction pressure (equivalent to -40 cm H2O) was applied but the subcutaneous emphysema progressed causing palpable cutaneous tension around her neck, dysphonia, dysphagia and palpebral closure (Fig. 2).
Three days after insertion of subcutaneous drain A) Improvement of facial swelling B) CT head and neck showing extent of facial subcutaneous emphysema C) CT chest demonstrating lung re-inflation and positions of ICC and subcutaneous drain.
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Her lung fully re-expanded after three days and a chest computed tomography (CT) confirmed resolution of her pneumothorax (Fig. 3).