Acupuncture-Induced Pneumothorax Following Thoracic Acupuncture in a Patient With Ehlers-Danlos Syndrome: A Case Report.

Acupuncture is widely used as an adjunctive therapy for chronic pain and headache disorders and is generally considered a safe procedure when performed by trained practitioners. However, pneumothorax remains one of its most serious, albeit uncommon, complications. Patients with connective tissue disorders, such as Ehlers-Danlos syndrome (EDS), may theoretically be more susceptible to procedure-related complications because of underlying tissue fragility, although reports describing acupuncture-induced pneumothorax in this population are exceptionally rare. We present the case of a young woman with EDS and chronic refractory cluster headaches who developed an iatrogenic left-sided pneumothorax following acupuncture involving the posterior thoracic region. She presented with sudden-onset pleuritic chest pain and progressive dyspnoea approximately three hours after treatment. Chest radiography demonstrated a 2.8-cm left apical pneumothorax. Needle aspiration removed approximately 450 mL of air and resulted in immediate symptomatic improvement, although repeat chest radiography demonstrated minimal reduction in the size of the pneumothorax. Following multidisciplinary discussion, she was managed conservatively with close inpatient observation. Computed tomography excluded underlying bullous lung disease or other structural abnormalities, and serial imaging demonstrated complete spontaneous resolution within 24 hours. This case highlights the importance of considering pneumothorax in patients presenting with respiratory symptoms following thoracic acupuncture and demonstrates that carefully selected, clinically stable patients may be managed conservatively in accordance with contemporary British Thoracic Society guidance.