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 bilate
ral localized tension pneumothoraces presenting in the pediatric age group.