Reexpansion pulmonary edema: A rare complication of pneumothorax drainage

Among all the noncardiac causes of pulmonary edema, unilateral reexpansion pulmonary edema is one of the rarest complication of expansion of a collapsed lung. It is largely unknown and a potentially fatal complication. We present the case of a 51-year-old gentleman who presented to our emergency department with shortness of breath. X-ray revealed significant right-sided pneumothorax with associated collapse of the right lung. An intercostal tube was inserted into the right 5(th) intercostal space and a repeat X-ray revealed well-expanded lung field. Soon, the patient developed increased shortness of breath and hypoxia. Repeat X-ray was suggestive of pulmonary edema. He was started on noninvasive positive pressure ventilation and responded well to it. Emergency physicians should have a high index of suspicion and initiate early management of reexpansion pulmonary edema in patients suffering from pneumothoraces which have undergone drainage.