LearningRadiology- Reexpansion Pulmonary Edema

Re-expansion Pulmonary Edema

Findings: There is unilateral air-space disease opacifying the entire right hemithorax. In addition a chest tube is seen on the same side. The chest tube was inserted for a large, right-sided, tension pneumothorax which was rapidly re-expanded. See image below of original right-sided, tension pneumothorax.

Pulmonary edema of cardiac or renal origin usually affects both lungs
Re-expansion pulmonary edema results from the too rapid expansion of a pneumothorax or the rapid removal of pleural fluid
Unilateral pulmonary edema can occur either because of an abnormality on the same side as the pulmonary edema or an abnormality on the opposite side
Examples of abnormalities on the same side as the pulmonary edema include:
- Venous obstruction confined to the ipsilateral side
- Prolonged positioning with the affected side dependent
- Bronchial obstruction (so-called “Drowned Lung”)
Examples of abnormalities in one lung which “spare” it and lead to pulmonary edema on the opposite side:
- Pulmonary artery obstruction
  - Congenital absence or hypoplasia of the pulmonary artery
  - Thromboembolism occluding one pulmonary artery
  - Unilateral arterial obstruction
- Abnormalities of the opposite lung itself
  - Unilateral emphysema
  - Pneumonectomy
  - Swyer-James syndrome