The Legend of the Buffalo Chest
Blacha, Marielle M J; Smesseim, Illaa; van der Lee, Ivo; van den Aardweg, Joost G; Schultz, Marcus J; Kik, Marja L J; van Sonsbeek, Linda; de Bakker, Bernadette S; Light, Richard W
(2021) Chest, volume 160, issue 6, pp. 2275 - 2282
(Article)
Abstract
BACKGROUND: The "buffalo chest" is a condition in which a simultaneous bilateral pneumothorax occurs due to a communication of both pleural cavities caused by an iatrogenic or idiopathic fenestration of the mediastinum. This rare condition is known by many clinicians because of a particular anecdote which stated that Native Americans
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could kill a North American bison with a single arrow in the chest by creating a simultaneous bilateral pneumothorax, due to the animal's peculiar anatomy in which there is one contiguous pleural space due to an incomplete mediastinum. RESEARCH QUESTION: What evidence is there for the existence of buffalo chest? STUDY DESIGN AND METHODS: The term "buffalo chest" and its anecdote were first mentioned in a ''personal communication'' by a veterinarian in the Annals of Surgery in 1984. A mixed method research was performed on buffalo chest and its etiology. A total of 47 cases of buffalo chest were identified in humans. RESULTS: This study found that all authors were referring to the article from 1984 or to each other. Evidence was found for interpleural communications in other mammal species, but no literature on the anatomy of the mediastinum of the bison was found. The main reason for this research was fact-checking the origin of the anecdote and search for evidence for the existence of buffalo chest. Autopsies were performed on eight bison, and four indeed were found to have had interpleural communications. INTERPRETATION: We hypothesize that humans can also have interpleural fenestrations, which can be diagnosed when a pneumothorax occurs.
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Keywords: buffalo chest, pleural diseases, pneumothorax, Pulmonary and Respiratory Medicine, Critical Care and Intensive Care Medicine, Cardiology and Cardiovascular Medicine
ISSN: 0012-3692
Publisher: American College of Chest Physicians
Note: Funding Information: Author contributions: M. M. J. B. and I. S. contributed equally to the literature search, figure creation, study design, data collection, data interpretation, and writing. I. v. d. L. J. G. v. n. A. M. J. S. M. L. J. K. L. v. S. B. S. d. e. B. and R. W. L. contributed to the study design, data interpretation, and writing. Financial/nonfinancial disclosures: None declared. Other contributions: The authors thank Bibi Kwa, MD, PhD, Kris Mooren, MD, Dominic Snijders, MD, PhD, Martin Bard, MD, PhD, Frans Krouwels, MD, PhD, Carla Weenink, MD, Christian Melissant, MD, Maarten Sulzer, MD, Jolien Lind, MD, PhD, Ivo van der Lee, MD, PhD, Kenneth Throlson, DVM, Pieter Cornillie, DVM, PhD, Louis van den Boom, DVM, Friso van Dalen, and Brush Meat Processors for their support for this research. FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study. Publisher Copyright: © 2021 The Authors
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