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1.( Pneumothorax):
(tension pneumothorax)
Spontaneous Primary pneumothorax Secondary pneumothorax Airway and pulmonary disease (COPD, asthma) Interstitial disease (Pulmonary fibrosis) Infection ( TB..) Neoplastic Catamenial ( Endometriosis) Iatrogenic Post-Traumatic
Potential hazard
Occupational hazard Absence of medical facilities in isolated areas Associated single bulla Psychological
Second Episode
Ipsilateral recurrence Contralateral recurrence after a first pneumothorax
Spontaneous Pneumothorax
-Definition & Factors
Definition
Accumulation of intrapleural air as the result of a break in either the visceral or parietal pleura
Spontaneous Pneumothorax
-Clinical investigation Signs and symptoms
Sudden onset chest pain Shortness of breathing Cough
Diagnosis
CXR Auscultation
Differential diagnosis
Skin fold Giant bulla
Tube thoracostomy
Water seal Pleur-evac type Heimlich valve
Tube thoracostomy with instillation of pleural irritant Video-assisted thoracoscopic surgery Thoracotomy
Large bulla Large undrained hemothorax First episode in a patient with one lung First episode in a patient with severely compromised pulmonary function
Recurrence (%)
30 20-50 20-30 25 7 2
Expectant Aspiration Chest tube drainage Pleurodesis (tetracycline) Pleurodesis (talc) Surgery
Complication of Pneumothorax
Tension pneumothorax Re-expansion pulmonary edema Persistent air leak Hemothorax (less than 5%) Pneumomediastinum
Tube Thoracostomy
( Chest Intubation)
Chest pain, great vessel Pain, unable in supine Air leakage Skin necrosis, pain
Abrupt mediastinal shift, venous return decrease, death Reexpansion pulmonary edeme
Disease flare up