A 73-Year-Old Man With Progressive Whole Body Subcutaneous Gas After Pleural Catheter Removal

Chest. 2019 Apr;155(4):e97-e100. doi: 10.1016/j.chest.2018.09.012.


A 73-year-old man presented to the ED of an outside hospital with asymptomatic chest wall swelling 10 h after discharge from our hospital. Four days earlier, he had presented to our hospital with increased dyspnea, cough, and sputum production. His history was notable for severe COPD with bullous emphysema. Chest imaging demonstrated bilateral opacities and a collection of gas and liquid in the major fissure of the left lung. A catheter was placed into the collection of gas and liquid under imaging guidance. After 4 days, the catheter was removed without event and the patient was discharged from the hospital with an extended course of antibiotics. Imaging performed in the ED revealed gas in the tissues of the chest wall and no evidence of a pneumothorax. He was transported back to our hospital by helicopter.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bronchial Fistula / complications*
  • Bronchial Fistula / diagnosis
  • Bronchial Fistula / surgery
  • Catheters / adverse effects*
  • Cutaneous Fistula / complications*
  • Cutaneous Fistula / diagnosis
  • Cutaneous Fistula / surgery
  • Decompression, Surgical / instrumentation*
  • Device Removal / adverse effects*
  • Humans
  • Male
  • Subcutaneous Emphysema / diagnosis
  • Subcutaneous Emphysema / etiology*
  • Subcutaneous Emphysema / surgery
  • Tomography, X-Ray Computed