1 / 9

Pneumothorax

Pneumothorax. Tintinalli Chapter 71. Epidemiology. 20,000 spontaneous ptx every year Risk factors Male Smoker Trimodal peaks: neonates, 20-40 yrs, >40. Pathophysiology. Iatrogenic Trauma or diagnostic procedure Spontaneous Primary: 2/3 No known lung disease Secondary

alida
Télécharger la présentation

Pneumothorax

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Pneumothorax Tintinalli Chapter 71

  2. Epidemiology • 20,000 spontaneous ptx every year • Risk factors • Male • Smoker • Trimodal peaks: neonates, 20-40 yrs, >40

  3. Pathophysiology • Iatrogenic • Trauma or diagnostic procedure • Spontaneous • Primary: 2/3 • No known lung disease • Secondary • Underlying lung disease • Air enters potential space between parietal and visceral pleura

  4. Clinical features • Symptoms relate to size of ptx, rate of development, underlying clinical status • Acute pleuritic chest pain, dyspnea, ↓ BS • Tachycardia, tachypnea, hypotension if large and have underlying disease • Tension: tracheal deviation and hemodynamic compromise • Hypoxia

  5. Diagnosis • Imaging • CXR • 83% sensitivity • CT • May be needed to confirm if small • US • Signs of pneumo on US include: • Absence of lung sliding • Multiple horizontal artifact lines • Absence of vertical comet tail artifacts

  6. Treatment • Small and stable ptx • May be able to monitor with no intervention • Catheter aspiration • Small sized catheter • Cook catheter • Uresil • Chest tube thoracostomy • Large, secondary ptx, recurrent ptx, abnormal vitals

  7. Disposition • Recurrence • Definitive treatment may be required • Pleurodesis/VATS • High rate of recurrence, lower cost, high success, better quality of life

  8. Iatrogenic PTX • Transthoracic needle procedures (thoracentesis and transthoracic needle bx) • 50% • Subclavian vein lines • 25% • Factors • Underlying disease, body habitus, operator experience • Post procedure CXR may miss since may be delayed presentation • Treatment • Chest Tube

  9. Sources • Tintinalli, Ch. 71

More Related