Pneumothorax with an azygos lobe

Case contributed by Dr Francis Fortin

Presentation

Fell from standing height.

Patient Data

Age: 75 years
Gender: Male
CT

Cropped CT images

The inferior portion of the azygos vein is hypoplastic, with a compensatory increase in size of the hemiazygos vein. A pneumothorax is seen extending under the fissure of an azygos lobe. Air is also seen outlining the azygoesophageal recess.

There is moderate hydropneumothorax with multiple rib fractures and subcutaneous emphysema.

Case Discussion

Despite azygos lobes occurring in up to 1% of people, reports of pneumothorax in patients with such variant anatomy are surprisingly rare 1-3. The pneumothorax here helps appreciate the anatomy of the azygos vein connecting with the superior vena cava, drawing down with it a thick double layer of pleura.

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Case information

rID: 61729
Published: 15th Jul 2018
Last edited: 14th Aug 2019
System: Trauma
Inclusion in quiz mode: Included

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