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        "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Spontaneous contralateral pneumothorax after pneumonectomy is a rare condition&#46; A high index of suspicion is required for a correct diagnosis&#46; Management can be challenging&#44; as surgical intervention&#44; if necessary&#44; is a very high risk procedure&#46;</p><p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Chemical pleurodesis can be a simple and effective measure in cases with no major air leak&#46; We describe the case of a 21-year-old female with spontaneous pneumothorax in a single lung&#44; which posed several diagnostic and therapeutic problems&#46; The presence of a &#8220;buffalo chest&#8221; made the initial chest x-ray interpretation difficult&#46; The patient had an important air leak without complete pulmonary expansion and thoracic surgery was considered of risk&#46; Accordingly&#44; instillation of talc slurry through one of the thoracic drains was undertaken with eventual resolution&#46; We are convinced that bronco-pleural fistula resolution was facilitated by <span class="elsevierStyleItalic">slurry talc</span>&#44; despite complete lung expansion never having been achieved&#46;</p>"
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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">O pneumot&#243;rax contralateral ap&#243;s pneumonectomia &#233; uma situa&#231;&#227;o rara&#46; &#201; necess&#225;rio um alto &#237;ndice de suspei&#231;&#227;o para um correcto diagn&#243;stico&#44; na aus&#234;ncia de exames complementares de diagn&#243;stico&#46; O tratamento &#233; um desafio&#44; uma vez que a interven&#231;&#227;o cir&#250;rgica&#44; se necess&#225;ria&#44; &#233; um procedimento de risco&#46; A pleurodese qu&#237;mica pode ser uma medida simples e eficaz&#44; em casos sem f&#237;stula broncopleural importante&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Descrevemos o caso cl&#237;nico de uma doente de 21 anos com pneumot&#243;rax espont&#226;neo em pulm&#227;o &#250;nico&#44; que colocou v&#225;rias dificuldades&#44; diagn&#243;sticas e terap&#234;uticas&#46; A presen&#231;a de pulm&#227;o vicariante dificultou a interpreta&#231;&#227;o inicial do RX tor&#225;cico&#46; A doente apresentava f&#237;stula broncopleural de alto d&#233;bito&#44; sem expans&#227;o pulmonar completa&#44; mesmo ap&#243;s coloca&#231;&#227;o de um segundo dreno tor&#225;cico&#44; e a cirurgia tor&#225;cica foi considerada de risco&#46; Foi efectuada instila&#231;&#227;o de talco atrav&#233;s de um dos drenos tor&#225;cicos&#44; com posterior resolu&#231;&#227;o&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estamos convencidos de que a resolu&#231;&#227;o da f&#237;stula broncopleural foi facilitada pela talcagem&#44; mesmo sem expans&#227;o pulmonar total&#44; que nunca se tinha conseguido&#46;</p>"
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A spontaneous pneumothorax in a “buffalo chest”
Pneumotórax espontâneo num pulmão vicariante
Anabela Marinho1,
Corresponding author
a.n.marinho@tvtel.pt

Correspondência: Serviço de Pneumologia do Hospital de S. João Alameda Professor Hernâni Monteiro, 4202-451 Porto, Portugal. Telefone: 225512100 ou 963311481, Fax: +00351225512215.
, Beatriz Lima2, Idalina Araújo3, Pedro Bastos4, J. Agostinho Marques5, Isabel Gomes6
1 Interna Complementar de Pneumologia do Hospital de S. João
2 Assistente Hospitalar de Pneumologia do Hospital de S. João
3 Assistente Hospitalar Graduada de Pneumologia do Hospital de S. João
4 Chefe de Serviço de Cirurgia Torácica do Hospital de S. João; Professor Associado Convidado da Faculdade de Medicina da Universidade do Porto
5 Chefe de Serviço de Pneumologia do Hospital de S. João; Professor Catedrático da Faculdade de Medicina da Universidade do Porto
6 Assistente Hospitalar Graduada de Pneumologia do Hospital de S. João
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