CHEST Guidelines-The-Legend-of-the-Buffalo-Chest_2021

The-Legend-of-the-Buffalo-Chest_2021_chest

Pdf Summary

"The Legend of the Buffalo Chest" explores the medical condition known as a 'buffalo chest,' where a simultaneous bilateral pneumothorax occurs due to interpleural communications in humans. This anomaly is compared to an anecdote about Native Americans killing bison with a single arrow by exploiting a similar anatomical feature in the animals where their pleural cavities are interconnected. <br /><br />The term was first used in 1984, based on information from veterinarian Dr. Kenneth Throlson, who observed that bison frequently died from unilateral chest wounds leading to bilateral pneumothorax. Despite its acceptance in medical literature and among clinicians, no direct evidence existed until this study aimed at verifying the phenomenon.<br /><br />A cross-species analysis revealed 47 human cases of 'buffalo chest,' mostly following thoracic surgeries or rare spontaneous developments. To validate this in bison, the researchers conducted autopsies on eight North American bison. They identified interpleural communications in four specimens, suggesting that while rare, such fenestrations do exist.<br /><br />This study involved consultations with numerous veterinary professionals and physical autopsies supported by photography, yielding mixed results due to the limitations of not being able to perform all investigatory methods on each bison, due to ethical and procedural restrictions. <br /><br />The research signifies that both bison and humans might develop these communications naturally or iatrogenically (surgically), which prompts a critical medical review in cases of pneumothorax for timely interventions, emphasizing the necessity for clinicians to consider bilateral pleural space examination to prevent potentially fatal complications like tension pneumothorax.<br /><br />Overall, this study confirms that while 'buffalo chest' was initially an unverified anecdote, evidence now supports its existence, warranting attention for potentially overlooked cases in various species, including humans.

Keywords

buffalo chest

bilateral pneumothorax

interpleural communications

Native Americans

bison anatomy

thoracic surgery

cross-species analysis

veterinary autopsies

tension pneumothorax

iatrogenic conditions