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Pneumothorax Following "Trigger Point" Injection

Nathaniel Shafer, MD
JAMA. 1970;213(7):1193. doi:10.1001/jama.1970.03170330073017.
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To the Editor:—  Antoni reviewed 226 cases of pneumothorax occurring in patients treated at the Henry Ford Hospital during the period 1955 to 1959, of which 76 were iatrongenically produced.1 Techniques used by the surgeons, otolaryngologists, internists, gastroenterologists, and anesthesiologists could be complicated by pneumothorax and he urged that all physicians be cognizant of this complication. Iatrogenic causes included scalene node biopsy, arterial catheterization, pneumoperitoneum, tracheotomy, and radical neck dissection. Although Osler mentions the occurrence of pneumothorax as a result of exploration with needles, he does not indicate after which procedure or explorations this may occur. Pleural biopsy, now a widely accepted procedure, may be complicated by pneumothorax as well as intercostal nerve injury or hemorrhage.We recently encountered a case of traumatic pneumothorax as a result of injection of "trigger-points" on the neck with a local anesthetic.

Report of a Case.—  A 29-year-old white man was admitted to

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