Re-expansion Pulmonary Oedema

Abstract

Background: Re-expansion pulmonary oedema is a rare complication following drainage of pneumothorax or pleural effusion, with a reported incidence of approximately 0.9%. Although uncommon, it can be life-threatening even in previously healthy individuals.

Case Report: A 48-year-old man presented with exertional breathlessness and right-sided chest pain due to a spontaneous right pneumothorax. Following tube thoracostomy, he initially improved but rapidly developed cough, hypotension, hypoxaemia, and radiographic evidence of extensive right lung consolidation consistent with re-expansion pulmonary oedema.

Management and Outcome: The patient was managed with oxygen therapy, bronchodilators, intravenous fluids, non-invasive ventilation, and close monitoring. Diuretics were avoided. He improved within hours, the intercostal tube was removed four days later, and he was discharged without complications.

Conclusion: Re-expansion pulmonary oedema should be suspected in patients who deteriorate after tube thoracostomy. Prompt recognition and supportive management, including correction of hypoxaemia and hypovolaemia, are essential for favorable outcomes.