What are possible presentations of pneumothorax?

Updated: Apr 28, 2020
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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Answer

The following are possible presentations of patients with pneumothorax:

  • Asymptomatic (incidental finding) - Treatment decisions are guided by estimate of long-term recurrence risk.
  • Symptomatic but clinically stable - Treatment is guided by local resources and conventions for the site of care; the British Thoracic Society (BTS) advocated for simple aspiration and deferring hospitalization in primary spontaneous pneumothorax (PSP) as initial management if the patient is stable[ref38}; a small-bore catheter or chest tube placement was recommended by the American College of Chest Physicians (ACCP) Delphi consensus statement [39]
  • Clinically fragile - Treatment is guided by local practice patterns for air evacuation and observation; comorbid conditions may preclude observation because of decreased cardiopulmonary reserve
  • Life-threatening - Pneumothorax that causes hemodynamic instability is life-threatening and must be treated immediately with tube thoracostomy; all documents and recommendations call for intervention if a patient is unstable

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