Although recent prospective studies came to the conclusion that the incidence of adverse events following acupuncture can be classified as minimal, many cases of acupuncture-related pneumothorax have been published over the years, among them some cases of tension pneumothorax. In this case, a slender woman received acupuncture from a fully trained medical acupuncturist including needling of the points LU1 in the subacromial region and BL13, which is a paravertebral point at the level of the spinous process of the third thoracic vertebra. During the final treatment, she experienced difficulties in breathing and pain in the left chest. On x ray examination a tension pneumothorax was diagnosed. Even though pneumothorax is the most frequently reported serious complication related to acupuncture, it is not an inevitable complication of acupuncture, and in most cases involves negligence from inadequate consideration of basic anatomy.
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