Images in Clinical Medicine
Buffalo Chest
N Engl J Med 2003; 349:1829November 6, 2003
- Article
A 66-year-old man was admitted to the hospital with a two-day history of left-sided pleuritic chest pain and progressive shortness of breath. A right pneumonectomy had been performed 17 years earlier for non–small-cell bronchogenic carcinoma. A computed tomographic scan showed anterior herniation of the left lung into the right hemithorax and a small bilateral pneumothorax (arrows). There was also evidence of a left hilar mass and counterclockwise rotation of the heart. The pneumothorax was attributed to the rupture of the herniated bullae. A chest tube was inserted and remained in place for several days; the symptoms resolved.
A single pleural space is sometimes called “buffalo chest” because the absence of anatomical separation of the two hemithoraxes resembles that in some North American buffalo, or bison. This anatomical anomaly helped the Indians of the Great Plains to thrive on hunting bison, which can be agile and reach speeds as high as 40 miles (65 km) per hour. An arrow or a single wound to the thorax frequently resulted in bilateral tension pneumothoraxes and the incapacitation of the bison.
Kurt W. Grathwohl, M.D.
Brooke Army Medical Center, Fort Sam Houston, TX 78234Stephen Derdak, D.O.
Wilford Hall Air Force Medical Center, Lackland Air Force Base, TX 78236- Citing Articles (3)
Citing Articles
1
V. Pettemerides, N. Jenkins. (2011) Contralateral pneumothorax following repositioning of an atrial lead. Europace
CrossRef2
Anabela Marinho, Beatriz Lima, Idalina Araújo, Pedro Bastos, J. Agostinho Marques, Isabel Gomes. (2007) Pneumotórax espontâneo num pulmão vicariante. Revista Portuguesa de Pneumologia (English Edition) 13:4, 613-617
CrossRef3
Alden M. Parsons, Frank C. Detterbeck. (2005) Of Buffaloes, Horseshoes, and Having No Connections. The Annals of Thoracic Surgery 80:4, 1521-1523
CrossRef
