Diagnosis and Management of Spontaneous Pneumothorax in the Emergency Department: A Review of the Most Current Clinical Evidence for Diagnosis and Treatment
Journal Title: Pulmonary Research and Respiratory Medicine – Open Journal - Year 2016, Vol 3, Issue 2
Abstract
Background Spontaneous non-traumatic pneumothorax is a relatively common clinical presentation in the Emergency Department. The diagnosis of spontaneous non-traumatic pneumothorax has evolved from basic chest radiography to the reference standard of CT imaging. Point-of-care ultrasound is another highly sensitive diagnostic modality that has gained increasing acceptance. Finally, the treatment of this type of pneumothorax has also been rapidly changing. Objective We give an overview of the current literature regarding the definition and classification for pneumothorax. We discuss the current methods of diagnosis and management of spontaneous non-traumatic pneumothorax, which now include the promising treatment alternative of smaller pigtail thoracostomy catheters. We also discuss how a rapidly placed smaller pigtail catheter may be a viable single management option for a spontaneous tension pneumothorax. Discussion The management of spontaneous non-traumatic pneumothorax has been rapidly advancing. Viable treatment options now include observation alone, needle aspiration and placement of a small pigtail thoracostomy catheter, in addition to the use of a traditional thoracostomy tube. Conclusion Although the traditional treatment for a spontaneous non-traumatic pneumothorax was placement of a larger thoracostomy tube, this may no longer be the optimal management approach in these patients. The use of smaller pigtail thoracostomy catheters provides a viable treatment alternative to these larger catheters, and may also be used effectively as the only treatment step in a spontaneous tension pneumothorax. Placement of these smaller catheters sets the stage for potential outpatient management of pneumothorax, with increased comfort for the patient and possible cost savings.
Authors and Affiliations
Ian D. Chong
Keywords
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- EP ID EP546536
- DOI 10.17140/PRRMOJ-3-127
- Views 212
- Downloads 0
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