Breast Implants and Bilateral Tension Pneumothorax Following Blunt Chest Trauma

Özet

A 38-year-old woman was admitted to our trauma centre with a complete left pneumothorax. The chest tube implementation procedure wasaborted quickly because of a very difficult dissection (subcutaneous emphysema over two voluminous breast implants). The patient was transferred to the imaging room without chest tube insertion due to respiratory and haemodynamic stability. During transfer, the patient presentedwith cardiac arrest due to tension pneumothorax. The time benefit with the use of immediate total body computed tomography has been reported. A simple and rapid initial imaging assessment including chest and pelvic X-rays and four‐chamber view and ‘swing technique’ ultrasoundprotocol enables the appropriate emergency decisions. While this diagnostic approach is time consuming, it nevertheless allows a reduction in thetime needed to initiate life-saving interventions for the most severe patients. This case reminds us that even if patients are stable, drainage of acomplete pneumothorax under mechanical ventilation should not be delayed, especially in case of technical difficulties.