Bilateral localized tension pneumothoraces refractory to needle decompression

We present the unusual case of a 12-year-old child with bilateral localized tension pneumothoraces that were initially both difficult to diagnose and refractory to needle decompression. This case illustrates several important variations in the diagnosis and treatment of tension pneumothorax. To the best of our knowledge, it also represents the only reported case of bilateral localized tension pneumothoraces presenting in the pediatric age group.