Asymptomatic re-expansion pulmonary edema - A rare occurence in clinical practice

Re-expansion pulmonary oedema (RPE) is a rare but often fatal complication which occurs due to rapid re-expansion of collapsed lung following treatment of conditions like a spontaneous pneumothorax or massive pleural effusion. The patho-physiology is still largely unknown, some of the reasons postulated include decreased surfactant levels, regional hypoxia, and hardened pulmonary microvasculature in collapsed lung and pro-inflammatory environment. Clinical manifestations vary from mild or no symptoms to life threatening hypoxia and cardio-respiratory failure. Early diagnosis and prompt treatment can save lives. Because of rarity of this fatal condition, we report a case of chronic obstructive pulmonary disease (COPD) with spontaneous pneumothorax who developed RPE following insertion of intercostal drainage (ICD) tube.