Pneumothorax managenet for student

1. By: M. SuleimanAljajeh
2014-2015
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2. 1. Definition
2. Types
3. Clinicalfeatures
4. Risk factors
5. Diagnosis
6. Treatment
7. Complications
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3. “Pneumothorax :is an abnormal
collection of air or gas in the pleural
space separating the lung from
the chest wall which may interfere with
normal breathing, causing the lungs to
collapse.”
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4. 1. Spontaneous pneumothorax:
Primary: It occurs in young healthy
individuals without underlying lung
disease. It is due to rupture of apical sub-
pleural bleb.
Secondary: occurs in the presence of pre-
existing lung pathology. Ex :Cystic lung
disease ,COPD, LUNG CANCER &T
.B
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5. 2. Traumaticpneumothorax:
Open:Chest wallis damaged by any wound -
-outside air enters pleuralspace and causes
lungs tocollapse.
Closed: herechest wallis punctured or air
leaks from a ruptured bronchus
Iatrogenic :Ex.PostoperativeMechanical
ventilation ,Thoracocentesis & Central
venous cannulation.
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6. 3.Tensionpneumothorax:
It is life threatening condition…The pleural
pressure is more than the atmospheric pressure.
Radiological manifestations of large
pneumothorax :
Mediastinal shift,
Flattening of the hemidiaphragm &
Lung collapse.
Associated with clinical manifestations of
circulatory collapse (tachycardia, hypotension &
sweating).
It is more common with
Positive pressure ventilation &
Traumatic pneumothorax.
ER
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8. The pleural cavity
pressure is < the
atmospheric
pressure
The pleural cavity
pressure is = the
atmospheric
pressure
The pleural cavity
pressure is > the
atmospheric pressure
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9. Predominant symptom is acute pleuritic chest pain
Dyspnoea results form pulmonary compression
On physicalexamination:
 Breath sounds may be diminished on the affectedside
 Percussion of the chest may be perceived as hyperresonant.
Physical signsinclude
 Tachypnoea
 Increased resonance
 Absent breathsounds
 Hypoxemia
 Cyanosis
 Hypercapnia 9

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12. Sex :men are farmore likely to have a pneumothorax than
arewomen.
Smoking.
Age. The type of pneumothorax caused by ruptured air
blisters is most likely to occur in people between 20 and 40
years old, especially if the person is a very tall and
underweight man.
Genetics.
Lung disease. Having an underlying lung disease —
especially chronic obstructive pulmonary disease (COPD) —
makes a collapsed lung more likely.
Mechanical ventilation.
Ahistory of pneumothorax.
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13. The characteristicsof
pneumothorax
 Pleural line
 No lung markings in
pneumothorax
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14. A further use ofCT is in the identificationof
underlying lunglesions
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15. Goals :
To promote lung expansion.
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Toeliminate the pathogenesis.
To decreasepneumothorax
recurrence.
Treatment options:
Simple aspiration
Intercostal tubedrainage
Guidewire tubethoracostomy
Surgical treatment

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19. Complications of pneumothorax
Recurrence of spontaneous pneumothorax
Tension pneumothorax
Hydropneumothorax
Encysted pneumothorax
Failure of expansion of the collapsed lung
Re-expansion pulmonary edema
Broncho-pleural fistula
Pneumomediastinum
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21. 1.Kumar and ClarkClinical Medicine
2.USMLE Step 2CK
3.Harrison's Principles of InternalMedicine
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