Acupuncture-related pneumothorax: a 14-case single-center series and a review of the literature.

BACKGROUND

Acupuncture is widely practiced and generally considered safe, yet pneumothorax remains a potentially serious adverse event. The clinical characteristics and optimal management of acupuncture‑related pneumothorax have not been fully clarified.

METHODS

We retrospectively reviewed patients diagnosed with acupuncture‑related pneumothorax at our institution between 2006 and 2026. Clinical characteristics, management strategies, and outcomes were analyzed. A focused literature review was also conducted using PubMed.

RESULTS

Fourteen patients were identified (median age, 48 years; range 30-73; 10 females). Pneumothorax occurred on the right side in 5 patients, on the left in 7, and bilaterally in 2. Most cases were classified as small pneumothorax according to the British Thoracic Society criteria. Six patients were managed conservatively, six underwent ambulatory drainage, and two required chest tube drainage with hospitalization. One patient presented with hemothorax. No recurrence was observed during follow‑up. A literature review identified 11 previously reported cases, including severe and fatal presentations.

CONCLUSION

Most cases of acupuncture‑related pneumothorax were mild and successfully managed with conservative or ambulatory treatment. However, severe complications can occur, underscoring the need for clinician awareness and prompt recognition of this potentially serious adverse event.