Pneumothorax Flashcards

1
Q

Definition

A

Presence of air in the pleural cavity

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2
Q

Causes

A
  • Rupture preumatoceles
  • Rupture tuberculous cavity
  • Rupture lung abscess.
  • Rupture surface alveoli in air trapping
  • Vigorous resuscitation
  • Chest wall trauma
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3
Q

Clinical picture

Symptoms

A
-Asymptomatic (in small pneumothorax) 
🌼 discovered accidentally  
-Symptomatic: 
🌼 Respiratory distress (⬆️⬆️ with tension pneumothorax). 
🌼 Symptoms of the cause
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4
Q

Chest examination

A

🌷
- Inspection → Unilateral decreased movement & unilateral bulge.
- Palpation → Decreased TVF & trachea shifted to opposite side.
- Percussion → Hyper resonance.
- Auscultation → Marked diminished breath sounds.
→ Coin test

🌷 Evidence of tension.
• Mediastinal shift
• Circulatory compromise
• Hearing a “hiss” of rapid exit of air under tension with the insertion of the thoracostomy tube

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5
Q

Investigations

A
  • Chest X-ray/CT → jet black opacity ± mediastinal shift to the opposite side
  • CT chest: may identify underlying pathology such as blebs
  • For the cause
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6
Q

Treatment

A

1- Small pneumothorax: usually resolve within 1 week.

2- Symptomatic:

  • Closed drainage with underwater seal.
  • Tube is inserted in the 2 nd space mid clavicular line.

3- Treat the underlying cause.

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