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poster
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THE
TREATMENT OF TRAUMATIC PNEUMOTHORAX
FROM TRIGGER POINT INJECTION USING
THE LUNG/LARGE INTESTINE DISTINCT MERIDIAN
Denise McKee, MD
David Mar, MD
Raphaelle Hernandez III, MS
ABSTRACT
Pneumothorax is a
potential complication of trigger point injection
on the torso. This case report discusses a
woman who developed pneumothorax immediately
following the injection. Treatment included
needling of the Lung/Large Intestine Distinct
Meridian. Her condition resolved within a
week, but further study is warranted.
KEY WORDS
Pneumothorax, Trigger
Point Injection, Lung/Large Intestine Distinct
Meridian
REPORT
OF A CASE
 A
43-year old white woman was given a left rhomboid
and a levator scapulae trigger point injection
with Traumeel and 1% lidocalne, using a 25-gauge,
11/2-inch needle. Within 5 minutes of the
shot, she became tachypneic, dizzy, and complained
of left-sided chest pain with inability to
take a deep breath. A chest radiograph revealed
a 15% to 20% left-sided pneumothorax.
The patient was treated
for pneumothorax on days 2 and 4 at the Lung/Large
Intestine Distinct Meridian Couplet and the
Lung auricular points bilaterally using 36-gauge,
I-inch
Tai Ji acupuncture needles for 20 minutes
each with manual needle stimulation.
After both treatments,
the patient
experienced dramatic improvement in left-sided
chest pain, shortness of breath, and ability
to expand her lung. On day 4, she was able
to do aerobic exercise, describing a feeling
of "waves of energy" reexpanding her lung.
On day 7, radiography revealed complete reexpansion
of her lung. 
TREATMENT
The Lung/Large Intestine
Distinct Meridian Couplet was used for treatment.
On posttraumatic pneumothorax days 2 and 4,
Tai Ji acupuncture needles (36-gauge, I -inch)
were inserted for 20 minutes at points LU
1, LI 15, and LI 18, as shown in Figures
I and 2. The Lung
auricular points were simultaneously needled,
as shown in Figure 3.
RESULTS
On day 1, a 15% to
20% left-sided pneumothorax was demonstrated.
On day 2, the pneumothorax was still present.
By day 7, following acupuncture treatment,
a complete resolution of the pneumothorax
was demonstrated on radiography.
  
DISCUSSION
Pneumothorax is a
potential complication of trigger point injection
and acupuncture needling on the torso. Resolution
of traumatic pneurnothorax has been reported
to take from 2 to 6 weeks. 1,2
Hence, the 7-day resolution shown in this
case is a significantly shortened recovery
time. Research on this treatment modality
is needed to determine if this case is unique,
or if it can be generalized as a recommended
treatment.
REFERENCES
1. Merck Manual of Diagnosis and Therapy.
17th ed. Whitehouse, NJ: Merck Research Laboratories;
1999:650.
2. Respiratory Medicine. 2nd ed. Philadelphia,
Pa: WB Saunders Co; 1994:2196-2197.
Figures
reprinted from HelmsJM. Acupuncture
Energetics: A ClinicalApproach for Physicians.
Berkeley, Calif. Medical Acupuncture Publishers;
1995.
AUTHORS
INFORMATION
Dr Denise McKee is an Associate Clinical Professor
in the Department of Family Medicine at the
University of Nevada School of Medicine.
Denise
McKee, MD
University of Nevada Dept. of Family and Community
Medicine
Brigham Bldg #316
Reno, NV 89557
Phone: 775-784-6180 - Fax: 775-784-4473
Dr
David Mar is an Assistant Clinical Professor
in the Department of Family Medicine at the
University of Nevada School of Medicine.
Raphaelle
Hernandez is a fourth-year medical student
at the University of Nevada School of Medicine.
Editor'sNote:
Poster presentation as originally presented
at the 1999 AAMA Symposium in Chicago, Illinois.
Reproduced in their entirety with minor editing.
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