Traumatic Pneumothorax Secondary to Acupuncture Needling

Acupuncture is a common form of therapy involving insertion of fine needles to alleviate nausea and various forms of pain. We describe a case of pneumothorax secondary to acupuncture. A 50-year-old woman presented to the emergency department with right-sided pleuritic chest pain. This was following a history of acupuncture and cupping treatment an hour earlier at a traditional practitioner for long-standing neck pain. On physical examination, the respiratory rate was 22 breaths per minute and her oxygen saturation was 100% on room air. Breath sounds were decreased on the right hemithorax with hyper resonance to percussion. Inspection of her back revealed multiple needling and cupping marks. A chest radiograph revealed a right-sided pneumothorax with an apex-cupola distance of 3.6 cm. She was put on high flow oxygen and a chest tube was inserted into the right chest wall. The patient was admitted. She had radiographic resolution of the pneumothorax four days later and was discharged uneventfully. Follow-up one week later in the clinic showed no radiographic recurrence of the pneumothorax.