Current aspects of spontaneous pneumothorax (original) (raw)
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Guidelines for the diagnosis and treatment of spontaneous pneumothorax
Archivos de …, 2008
Spontaneous pneumothorax, or the presence of air in the pleural space not caused by injury or medical intervention, is a significant clinical problem. We propose a method for classifying cases into 3 categories: partial, complete, and complete with total lung collapse. This classification, together with a clinical assessment, would provide sufficient information to enable physicians to decide on an approach to treatment. This update introduces simple aspiration in an outpatient setting as a treatment option that has yielded results comparable to conventional drainage in the management of uncomplicated primary spontaneous pneumothorax; this technique is not, as yet, widely used in Spain.
Pathophysiology, clinical evaluation and treatment options of spontaneous pneumothorax
Tüberküloz ve toraks, 2010
An apical subpleural bleb is most common pathology of primary spontaneous pneumothorax however, chronic obstructive pulmonary disease is most common cause of secondary spontaneous pneumothorax. The diagnosis is confirmed by physical examination, chest radiography and thoracoscopic examination. The typical person who present has an asthenic body, being taller and thinner than the average person. Spontaneous pneumothorax can seen in some special part of life such as; catamenial pneumothorax and during pregnancy. Therapeutic options of primary spontaneous pneumothorax is include the conservative, intermediate and invasive procedure. In conclusion we aimed the report pathophysiology, clinical evaluation and treatment options of spontaneous pneumothorax in the light of literatures with a review article.
ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax
The European respiratory journal, 2015
Primary spontaneous pneumothorax (PSP) affects young healthy people with a significant recurrence rate. Recent advances in treatment have been variably implemented in clinical practice. This statement reviews the latest developments and concepts to improve clinical management and stimulate further research.The European Respiratory Society's Scientific Committee established a multidisciplinary team of pulmonologists and surgeons to produce a comprehensive review of available scientific evidence.Smoking remains the main risk factor of PSP. Routine smoking cessation is advised. More prospective data are required to better define the PSP population and incidence of recurrence. In first episodes of PSP, treatment approach is driven by symptoms rather than PSP size. The role of bullae rupture as the cause of air leakage remains unclear, implying that any treatment of PSP recurrence includes pleurodesis. Talc poudrage pleurodesis by thoracoscopy is safe, provided calibrated talc is ava...
Electronic Journal of General Medicine
INTRODUCTION Primary spontaneous pneumothorax (PSP) is a common health problem in patients referring to emergency departments (1). Primary spontaneous pneumothoraces occur in people aged 20-30 years and peak incidence is in the early twenties (2). For men, age-adjusted incidence of primary spontaneous pneumothorax is 7,4 to 18 cases per 100,000 persons per year (3). The overall recurrence rate is about 23 to 50% for primary spontaneous pneumothorax after the first attack (2). PSP is typically associated with the rupture of an apical subpleural bleb with no other predisposing lung disease or history of trauma (4). Several treatment options are available for the treatment of PSP such as observation, supplemental oxygen, and simple aspiration, tube thoracostomy with or without the installation of a sclerosing agent, thoracoscopy, and open thoracotomy. A consensus does not exist concerning the treatment of PSP (5).
Etiology of primary spontaneous pneumothorax
Jornal Brasileiro de Pneumologia, 2016
With the advent of HRCT, primary spontaneous pneumothorax has come to be better understood and managed, because its etiology can now be identified in most cases. Primary spontaneous pneumothorax is mainly caused by the rupture of a small subpleural emphysematous vesicle (designated a bleb) or of a subpleural paraseptal emphysematous lesion (designated a bulla). The aim of this pictorial essay was to improve the understanding of primary spontaneous pneumothorax and to propose a description of the major anatomical lesions found during surgery.
INDIAN JOURNAL OF APPLIED RESEARCH X 695 Clinical Study of Spontaneous Pneumothorax
Background: Pneumothorax is classified into traumatic and spontaneous. Spontaneous pneumothorax divided into primary spontaneouspneumothorax if there is no clinical evidence of lung disease and secondary spontaneous pneumothorax associated with lung disease. Method: Prospective observational study done at Pulmonary medicine department, Kurnool medical college. We studied the causes, presenting features, management and outcome of Spontaneous Pneumothorax in this study. Patients admitted in pulmonary medicine ward with a diagnosis of spontaneous pneumothorax were classified as primary spontaneous Pneumothorax (PSP) and Secondary spontaneous Pneumothorax (SSP). The diagnosis was made by chest radiograph, and computed Tomography if necessary. Necessary investigations done for confirmation of lung disease in SSP. Depending on clinical features, extent of pneumothorax and underlying lung disease management decided as observation with oxygen inhalation or aspiration or Intercostal ChestTube Drainage (ICTD) with under water seal. Supportive treatment given to all patients and Specific treatment for underlying lung disease given in SSP. Results : Total 69 patients were included in this studymales were more 48(69.6%). Mean age was 44.9 yrs(range 20 to 70 yrs). Out of 69 PSP were 10 (14.5%) and SSP were 59(85.5%). Lung diseases in SSP were Tuberculosis 33, Chronic obstructive pulmonary (COPD) disease 20, Asthma 2, interstial lung diseases 2 and pneumonia2. Treated with observation and oxygen inhalation 4 , with aspiration10 and with ICTD 55.In PSP cases lung expansion occurred-in 2 to 8 days. In SSP cases lung expansion occurred in 4-30 days.4 cases of SSP referred for surgery. Conclusion:Spontaneous Pneumothorax is more common in males.In majority of PSP dyspnoea is less, can be managed by observation with oxygen inhalation or by aspiration.Tuberculosis is the common cause for SSP in India and should be looked for in all spontaneous pneumothorax cases. Majority cases of SSP are managed by ICTD. Compared to SSP hospital stay in PSP is short Introduction : Pneumothorax is an emergency so early recognition and prompt treatment saves the patient. Pneu-mothorax classified into spontaneous and traumatic. Spontaneous pneumothorax divided into primary spontaneous Pneumothorax (PSP) if there is no clinical evidence of lung disease and secondary spontaneous pneumothorax (SSP) associated with underlying lung disease 1. This study is under taken to study the causes, clinical presentation, mode of management and response to treatment in spontaneous pneumothorax
The utility of computed tomography in the management of patients with spontaneous pneumothorax
Journal of Pediatric Surgery, 2011
Background: Spontaneous pneumothorax may result from rupture of subpleural blebs. Computed tomography (CT) has been used to identify blebs to serve as an indication for thoracoscopy. We reviewed our experience with spontaneous pneumothorax to assess the utility of CT in these patients. Methods: A retrospective review was conducted of all patients who underwent an operation for spontaneous pneumothorax from January 1999 to October 2009. All procedures were performed thoracoscopically. Results: We identified 39 pneumothoraces in 34 patients who underwent evaluation and a procedure for spontaneous pneumothorax. Mean age was 16.1 years (range, 10-23 years), with an average of 1.7 spontaneous pneumothoraces before operation (range, 1-4). Preoperative chest CT scans were obtained in 26 cases. Blebs were demonstrated on 8 CT scans. The presence of blebs was confirmed at operation in all 8 patients. Of the 18 negative scans, 14 (77.8%) were found to have blebs intraoperatively, 7 of these patients were initially managed nonoperatively and developed recurrence. The sensitivity of CT for identifying blebs was 36%. Conclusions: Chest CT does not appear to be precise in the identification of pleural blebs and a negative examination does not predict freedom from recurrence. Operative decisions should be based on clinical judgment without the use of preoperative CT.