Breast Implants and Bilateral Tension Pneumothorax Following Blunt Chest Trauma [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-73669 | DOI: 10.5152/TJAR.2019.73669  

Breast Implants and Bilateral Tension Pneumothorax Following Blunt Chest Trauma

Mathieu Martin, David Lobo, Jennifer Jaubert, Paul Henri Jost, Fabrice Cook
urgical Intensive Care Unit – Trauma Center, Department of Anesthesiology and Critical Care Medicine, Paris-Est Créteil University and Assistance-Publique Hôpitaux de Paris, Henri Mondor University Hospital, Créteil, France

A 38-year-old woman was admitted to our trauma centre with a complete left pneumothorax. The chest tube implementation procedure was aborted 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 presented with 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’ ultrasound protocol enables the appropriate emergency decisions. While this diagnostic approach is time consuming, it nevertheless allows a reduction in the time needed to initiate life-saving interventions for the most severe patients. This case reminds us that even if patients are stable, drainage of a complete pneumothorax under mechanical ventilation should not be delayed, especially in case of technical difficulties.

Keywords: Blunt chest trauma, breast implants, tension pneumothorax

Corresponding Author: Mathieu Martin, France

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