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Canadian Respiratory Journal
Volume 17, Issue 2, Pages 53-55
Case Report

Unilateral Re-Expansion Pulmonary Edema following Treatment of Pneumothorax with Exceptionally Massive Sputum Production, followed by Circulatory Collapse

Teruya Komatsu,1 Sumiya Shibata,1 Ryutaro Seo,2 Keisuke Tomii,2 Kyousuke Ishihara,2 Takurou Hayashi,3 and Yutaka Takahashi1

1Department of General Thoracic Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
2Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
3Department of Emergency Medicine, Kobe City Medical Center General Hospital, Kobe, Japan

Copyright © 2010 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A case of a 61-year-old man who developed ipsilateral re-expansion pulmonary edema after pleural drainage for a right pneumothorax is described. The patient’s chest x-ray revealed a totally collapsed right lung. After insertion of a chest drainage tube, he began to produce a moderate amount of serous, yellowish sputum. Despite continuous positive airway pressure support, his dyspnea gradually worsened and his oxygenation could not be maintained; therefore, to improve his hypoxemic state, intubation was necessary. His chest x-ray following chest tube insertion showed ipsilateral diffuse infiltrates. These radiographic and physical findings were consistent with re-expansion pulmonary edema. The present case was complicated by extreme hypotension and tachycardia due to massive fluid loss. His condition gradually improved with invasive mechanical ventilation. Re-expansion pulmonary edema is an uncommon complication of pleural drainage for pneumothorax, and therapy is supportive. In the present case, the exceptional severity of the pulmonary edema, as well as its general concept, is reviewed in accordance with other relevant literature.