Unilateral reexpansion pulmonary edema (clinical observations)

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Abstract

BACKGROUND: In clinical practice, pulmonary edema still remains one of the threatening conditions with high mortality, despite the sufficiently large attention from the investigators. The classic pulmonary edema is well studied, having its specific x-ray signs, while the unilateral pulmonary edema occurs rarely and causes difficulties in the differential diagnostics performed by the radiologist. CLINICAL CASE DESCRIPTION: The presented material includes cases of ipsi- and contralateral unilateral reexpansion pulmonary edema. These complications have developed as a consequence of rapid evacuation of the pathological content from the pleural cavity. CONCLUSION: Reexpansion pulmonary edema is a rare, though potentially life-threatening condition, which usually occurs as a result of rapid expansion of long-term collapsed lung, for example, in cases of pneumothorax and pleural effusion. The edema may develop several hours after the expansion of the atelectasis.

About the authors

Oleg I. Nikitin

Pirogov Russian National Research Medical University

Email: nikitinolegigor@bk.ru
ORCID iD: 0009-0008-2679-7608
Russian Federation, Moscow

Aracbathinia O. Khalimalova

Pirogov Russian National Research Medical University

Email: arac1998@mail.ru
ORCID iD: 0009-0001-7555-4062
Russian Federation, Moscow

Andrey L. Yudin

Pirogov Russian National Research Medical University

Email: prof_yudin@mail.ru
ORCID iD: 0000-0002-0310-0889
SPIN-code: 6184-8284

MD, PhD, Professor

Russian Federation, Moscow

Elena A. Yumatova

Pirogov Russian National Research Medical University

Author for correspondence.
Email: yumatova_ea@mail.ru
ORCID iD: 0000-0002-6020-9434
SPIN-code: 8447-8748

MD, PhD, Assistant Professor

Russian Federation, Moscow

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2. Fig. 1. Patient K., 38 years old. Chest radiograph: subtotal shadowing of the left side of the chest up to the level of the anterior segment of the II rib on the left side, due to pleural effusion (arrow).

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3. Fig. 3. Patient A., 53 years old. Radiograph of the thoracic cavity. Spontaneous pneumothorax on the right side, collapsed right lung (arrow).

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4. Fig. 4. Patient A., 53 years old. Computed tomography of the chest cavity: a - air accumulation in the right pleural cavity (arrow), soft tissue emphysema of the anterior chest wall; b - air accumulation in the right pleural cavity (arrow), soft tissue emphysema of the anterior chest wall; decreased airiness of the left lung parenchyma of the frosted glass type due to re-expansive edema (arrow head).

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5. Fig.2. Female patient К., 38 years of age. Computed tomography image of the thoracic cavity: а — effusion in the pleural cavity (arrow), collapsed lower lobe of the left lung (point of arrow); b — one hour after draining the pleural cavity: decrease transparence of the pulmonary tissue (ground glass-type), foci of consolidation within the basal segments left lung, caused by the reexpansion edema (arrow).

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6. Fig.4. Female patient А., 53 years of age. Computed tomography image the thoracic cavity: а — air accumulation in the right pleural cavity (arrow), emphysema in the soft tissues in the anterior wall of the chest; b — air accumulation in the right pleural cavity (arrow), emphysema in the soft tissues in the anterior wall of the chest; decreased airness in the parenchyma of the left lung (ground glass-type), resulting due to reexpansion edema (point of arrow).

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