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PNEUMOTHORAX is the presence of air in the
pleural space.
can be
a) Spontaneous
b) Result of iatrogenic injury
c) Trauma to the lung or chest wall
Classification
1. Spontaneous
# Primary
- No evidence of overt lung disease
- occurs in males aged 15-30
- air escapes from the lung into the pleural
space through rupture of a small emphysematous
bulla or pleural bleb
- smoking, tall stature & the presence of apical subpleural
blebs are additional risk factors
#Secondary
- underlying lung disease
- occurs mainly in males above 55 yrs
- most commonly COPD & TB
- also seen in asthma, lung abscess, pul infarcts,
bronchogenic carcinoma, all forms of fibrotic &
cystic lung disease
2. Traumatic
3. Tension pneumothorax
Closed type
Communication b/n airway and the pleural space
seals off as the lung deflates
Infection uncommon
Open type
Communication b/n pleura & bronchus doesn’t
seals off (Bronchopleural fistula)
Breathlessness
Cyanosis
Shift of trachea
breathing.
Investigations
Chest x ray
Shows : increased radiolucency, with absence of
bronchovascular markings
extend of mediastinal shift.
pleural fluid ,if present .
underlying pulmonary disease .
(costophrenic angles are clear)
[care must be taken to differentiate b/n a large pre-existing bulla &
a pneumothorax to avoid misdirected attempts at aspiration]
CT