User:Bron766/My Portfolio/PTX


 * Pneumothorax is air (pneumo) in the pleural space (in the thorax).

Variations:
 * Tension pneumothorax:
 * Simple pneumothorax
 * Primary
 * Secondary
 * Traumatic pneumothorax
 * Bilateral pneumothoraces
 * Catamenial pneumothorax
 * (during menstruation, rare)

Causes: Air can enter the pleural cavity either from the lungs through the visceral pleura (e.g. by rupture of a bullus), or through the chest wall (e.g. with chest trauma).

Consequences:
 * Immediate:
 * Pain
 * Cardiovascular compromise with a tension pneumothorax
 * Subcutaneous emphysema
 * Long term:
 * Recurrence

Diagnosis:

Symptoms:
 * Chest pain
 * Sudden onset
 * Pleuritic, sharp
 * Shortness of breath

PMHx:
 * COPD?
 * Smoking?

Signs:

Investigations:
 * Chest x-ray
 * Tension pneumothorax diagnosis is clinical and should NOT require a chest x-ray
 * Small apical pneumothoraces are easily missed
 * Inspiration and expiration films may not be required...
 * CT chest
 * May detect small pneumothoraces missed on x-ray

Treatment:
 * Stabilise and resuscitate
 * Observation
 * High flow oxygen
 * to speed reabsorption
 * Aspiration
 * Chest tube and underwater sealed drain
 * +/- ultrasound guidance
 * Video-Assisted Thoracoscopic Surgery (VATS)
 * Thoracotomy

Further:
 * Pleurodesis
 * Education regarding recurrence risk


 * Chest drain troubleshooting