A new clinical presentation: breast implant pneumocapsule and pneumothorax following penetrating chest wall trauma

Ann R Coll Surg Engl. 2021 Mar;103(3):e98-e100. doi: 10.1308/rcsann.2020.7038.

Abstract

Pneumothorax resulting from traumatic thoracic injury is a potentially life-threatening emergency requiring prompt recognition and management with an intercostal drain. A 34-year-old woman was brought into the emergency department after sustaining a stab injury to the right upper outer quadrant of the right breast. She described noticing a jelly-like substance from her wound, on the background of a prior cosmetic breast augmentation. On examination, it was noted that the right breast was significantly swollen. Computed tomography demonstrated a large right sided pneumothorax with associated punctured right breast implant, a 'pneumocapsule' and extensive subcutaneous emphysema of the breast. This case highlights that the fibrous tissue capsule around a breast implant can function as an anatomical space in continuity with the thoracic cavity, masking the diagnosis of pneumothorax in penetrating trauma.

Keywords: Breast capsule; Breast implants; Penetrating; Pneumothorax; Thoracic injuries; Trauma; Wounds.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Breast / diagnostic imaging
  • Breast / injuries
  • Breast Implants*
  • Chest Tubes
  • Female
  • Humans
  • Lacerations
  • Liver / diagnostic imaging
  • Liver / injuries
  • Pneumothorax / diagnostic imaging*
  • Pneumothorax / etiology
  • Pneumothorax / therapy
  • Subcutaneous Emphysema
  • Thoracic Injuries / complications
  • Thoracic Injuries / diagnostic imaging*
  • Thoracostomy
  • Tomography, X-Ray Computed
  • Wounds, Stab / complications
  • Wounds, Stab / diagnostic imaging*