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Tension pneumothorax with empyema from gastric ulcer perforation
  1. Yojiro Yutaka1,
  2. Hiromichi Katakura1,
  3. Susumu Noguchi1,
  4. Katsuaki Ura2,
  5. Akira Yamanaka1
  1. 1Respiratory Disease Center, Otsu Red Cross Hospital, Otsu, Shiga, Japan
  2. 2Digestive Surgery, Otsu Red Cross Hospital, Otsu, Shiga, Japan
  1. Correspondence to Dr Hiromichi Katakura, Respiratory Disease Center, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu, Shiga 520-8511, Japan; katakura{at}otsu.jrc.or.jp

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A 77-year-old man was admitted to our hospital with a 2-day history of dyspnoea that had started suddenly. Chest x-ray showed a left hydropneumothorax under tension with mediastinal shift (figure 1); blood analyses revealed a high inflammatory reaction. Chest drainage improved symptoms initially with re-expansion of the collapsed lung and a yellowish purulent effusion discharged from the chest drain with little or no air leakage under continuous suction. Biochemical test results of the fluid included: lactate dehydrogenase (LDH) 1522 IU/l, glucose 2 mg/dl and protein 5.7 g/dl.

Figure 1

Chest x-ray showing a left hydropneumothorax under tension with …

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