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. 2014 Aug 1;26(4):241-245.
doi: 10.1089/acu.2013.1022.

Acupuncture-Related Pneumothorax

David A Hampton  1 , Robert T Kaneko  2 , Erika Simeon  1 , Alexis Moren  1 , Susan Rowell  1 , Jennifer M Watters  1
Affiliations

Acupuncture-Related Pneumothorax

David A Hampton et al. Med Acupunct. .

Abstract

Background: Acupuncture-related pneumothorax (PTX) is a poorly reported complication of thoracic needling. Recent Chinese literature reviews cited PTXs as the most common adverse outcome. Because of delayed presentation, this complication is thought to be underrecognized by acupuncturists and is largely addressed by hospital and emergency room personnel. The goal of this case study was to demonstrate common risk factors for a PTX, the mechanisms for its development, and protocols to use if one is suspected. Case: A 43-year-old, athletic female with chronic neck pain that was poorly managed with oral medications sought an alternative intervention for pain control. Her treatment plan consisted of weekly acupuncture sessions in the prone and supine positions targeting points along the Bladder, Gall Bladder, and Small Intestine meridians, as well as the right scapular Ah Shi point. She also received infrared lamp therapy. The aim of this approach was to help the patient achieve subjective pain reduction and increased range of motion. Results: One hour after her third treatment session, this patient experienced pleuritic chest pain and dyspnea. She was transported to a local Level-1 trauma center by emergency medical services and was diagnosed with a right-sided PTX. Conclusions: The acupoints addressed, a practitioner's knowledge of variations in anatomy, and a patient's body habitus and medical history are risk factors for PTX development. A patient's initial presentation does not predict future outcome. A benign presentation can evolve into a potentially life-threatening cardiovascular collapse. When PTX is suspected, discussing it with the patient and facilitating appropriate evaluation and intervention by a tertiary-care facility is warranted.

Keywords: Acupuncture; Body Mass Index; Pneumothorax; Risk Factors.

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Figures

<b>FIG. 1.</b>
FIG. 1.
Posterior thorax. The shaded rectangle medial to the scapula represents the area instrumented.
<b>FIG. 2.</b>
FIG. 2.
Admission chest radiograph. The patient, J.K. was a 43-year-old female who presented with shortness of breath and diaphoresis 1 hour after receiving acupuncture near her right scapula. This chest radiograph shows a right apical pneumothorax, measuring 2.37 cm.
<b>FIG. 3.</b>
FIG. 3.
Discharge chest radiograph. Eighteen hours after the incident J.K.s pneumothorax was still present but had slightly decreased in size.
See this image and copyright information in PMC

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