If an air leak causes pneumothorax, immediate removal of air from the chest allows the lungs to re-expand.
He has a tension pneumothorax pressing on his heart.
Some children with Marfan develop cystic disease of the lungs or recurrent spontaneous pneumothorax, which is a condition in which air accumulates in the space around the lungs.
Try an alternative route ON THE SAME SIDE unless chest radiography is available to exclude any possible pneumothorax.
A chest X ray showed an apical pneumothorax on the left side with inferior displacement of the distal fracture segment.