Traumatic pneumothraks
Trauma
Iatrogenic pneumothoraks
Intervention transthoracic, needle aspiration , subclavian vessel
puncture, thoracocentesis, pleural biopsy and mechanical ventilation
Catamenial pneumothoraks
Before or after mensturasion
SSP is associated with a higher morbidity and
mortality than PSP. (D)
Strong emphasis should be placed on smoking
cessation to minimise the risk of recurrence. (D)
Pneumothorax is not usually associated with physical
exertion. (D)
Air entry in the potential space between
the visceral and parietal pleura
collapse lung tissue.
Clinical manifestation:
- Decreased breath sounds on the affected
side
- Percussion: hipersonor
- Ro-toraks: hiperlusen avasculer
Therapy: installation of chest tube at ICS
4 or 5, the midaxilaris anterior
Direct
relationship between :
The pleural cavity - The outside world
ec a serious wound to the chest wall
Clinical manifestations:
- Sound like awhistle when breathing
(sucking chest wound)
- Barely audible breath sound
- Percussion: hipersonor
Treatment:
Installation of gauze 3 sides
Occur due ventiles mechanism (one way
valve)
Inspiration : the air got into the pleural cavity,
Expiration : the air trapped in the pleural cavity
continuing Increasing the Pressure
Initialtherapy: needle thoracosintesis
Definitife therapy: WSD installation
Symptoms in PSP may be minimal or absent
Symptoms are greater in SSP, even if the
pneumothorax is relatively small in size. (D)
The presence of breathlessness influences the
management strategy. (D)
Severe symptoms and signs of respiratory
distress suggest the presence of tension
pneumothorax. (D)
Standard erect chest x-rays (while
inspiration) initial diagnosis of
pneumothorax. (A)
The widespread adoption of digital
imaging (PACS) requires diagnostic caution
and further studies since the presence of a
small pneumothorax may not be
immediately apparent. (D)
CT scanning is recommended for uncertain
or complex cases. (D)
In defining a management strategy, the size of a
pneumothorax is less important than the
degree of clinical compromise. (D)
The differentiation of a large from a small
pneumothorax continues to be the presence of a
visible rim of >2 cm between the lung margin
and the chest wall (at the level of the hilum) and
is easily measured with the PACS system. (D)
Accurate pneumothorax size calculations are
best achieved by CT scanning. (C)
Patients with pre-existing lung disease tolerate a
pneumothorax less well, and the distinction between PSP
and SSP should be made at the time of diagnosis to guide
appropriate management. (D)