Pneumothorax
After fall, has chest pain, and SOB. CXR is as below. What is the cause? What to do next.
Etiology - Spontaneous
- Primary Spontaneous
- No Prior Lung Disease
- <2-3 cm: NC Oxygen and observation
- >2-3 cm: Needle aspiration
- Symptomatic: Needle aspiration .
- When needle aspiration fails in above - Tube thoracostomy. May need thoracoscopy as well.
- Recurrent PSP or with hemothorax: Needs thoracoscopy.
- If thoracoscopy not available. Then pelurodesis can be considered.
- Clinically unable. Tube thoracostomy.
- Secondary Spontaneous
- Presence of Prior Lung Disease
- Carries increased risk of adverse outcome. Hence, all patient should be hospitalized except for cystic fibrosis with < 1 cm
- Oxygen for all
- Large > 2 cm: Tube thoracostomy
- Small 1 -2 cm: Small bore chest tube
- Very small < 1 cm: Observation
- Traumatic
Mucous Plug
- HYPOTHERMIA
Hypothermia: Case 41-2009 (Frostbite)
- SARCOIDOSIS
Pulmonary Vascular Disease (VTE disorders : Please see Thrombotic Disorders in Hematology/Oncology) High altitude related illness and Misc
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