PMID: 15362555Sep 15, 2004Paper

Pneumothorax

Kyobu geka. The Japanese journal of thoracic surgery
Koichi Kaneko

Abstract

Most of the patients with spontaneous pneumothorax are young male adults without significant pulmonary disease and the prognosis in these patients is usually very good. But in a few cases when tension pneumothorax develops, immediate diagnosis and chest tube drainage is required to avoid life-threatening emergency. Needless to say mechanical ventilation with tracheal intubation is contraindication even if the patient has severe respiratory distress or hypoxia. Re-expansion pulmonary edema is another severe complication. This occurs to a long-term (over 1 week) complete collapse lung when it is rapidly re-expanded with high negative pressure. To treat such patient it is necessary to decompress the lung slowly using lower negative pressure or water seal suction. When persistent bleeding of hemothorax is present, it is important to decide to perform open thoracotomy or video-assisted thoracoscopic surgery to avoid blood transfusion. The diagnosis of pneumothorax is simply done by chest X-ray film. When the pneumothorax is suspected, chest X-ray examination has to be done first. A scheduled operation to prevent recurrence of pneumothorax has to be performed under relative indication in consideration of both the medical factor and t...Continue Reading

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