Value of computed tomography of the lung in the management of primary spontaneous pneumothorax

Article Abstract:

Primary spontaneous pneumothorax is usually caused by a rupture of a bleb under the pleura (lining of the lung) with subsequent entrance of air into the pleural cavity, without any underlying lung disease or injury. This condition may cause collapse of the lung. Treatment of spontaneous pneumothorax is controversial because the natural course of the disease for a particular patient is unpredictable. The risk of recurrence after a single episode is 30 to 50 percent; this increases to 62 percent after a second episode, and 80 percent after three episodes. The usual treatment is placement of a tube in the chest cavity until the air leak stops. It would be helpful to be able to predict treatment failure and recurrence of pneumothorax as a means of identifying patients who will eventually require thoracostomy (chest surgery). Early definitive surgical treatment can reduce heart and lung instability and reduce hospital costs. A study was undertaken of 26 patients with primary spontaneous pneumothorax to determine if computed tomography of the lung could identify the number and size of lung blebs, and if this finding would correlate with either recurrence of pneumothorax or need for thoracostomy. A bleb score was calculated (a numeric value was given to a range of bleb sizes; this was multiplied by the number of blebs). Both bleb score and number of blebs was significantly higher in patients with a history of pneumothorax recurrence and/or patients who eventually required thoracostomy. This finding suggests that computed tomographic scanning can be helpful in predicting the course of pneumothorax, and improve treatment of patients with primary spontaneous pneumothorax. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Usage, Prevention, CT imaging, CAT scans

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Primary spontaneous tension pneumothorax in a submariner at sea

Article Abstract:

Tension pneumothorax is a collection of air in the potential space between the parietal and visceral pleura. A case study of 23-year-old sailor on the nuclear submarine highlights importance of rapid recognition of tension pneumothorax and the treatment of such life threatening condition is discussed.

Case studies, Diseases, Sailors

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Bochdalek hernia masquerading as a tension pneumothorax

Article Abstract:

Bochdalek hernia is caused due to failure of fusion of the lateral with the posterior components of the diaphragm commonly on the left. Tension pneumothorax can lead to herniation and can be life threatening, if not treated on time.

Analysis, Risk factors, Hernia

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