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Spontaneous
Pneumothorax
By: Dr. Ismah
Reference: Management of spontaneous pneumothorax,
British Thoracic Society pleural...
06/08/2014
2
06/08/2014
3
06/08/2014
4
06/08/2014
5
06/08/2014
6
Suction
• Not routinely used because may cause re expansion
pulmonary edema
• Indicated when persistent air leak with or w...
Bronchopleural fistula
• Communication between the bronchial tree and pleural space.
• Persistent air leak or a failure to...
Thoracic surgeon
Indications for surgical advice:
• Persistent air leak (despite 5 to 7 days of chest tube drainage)
or fa...
Advice & f/up
• Avoid air travel until 1 weeks post fully resolution
• Avoid diving unless has undergone bilateral surgica...
THANK YOU
06/08/2014
11
Tension Pneumothorax
06/08/2014
12
06/08/2014
13
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Pneumothorax

  1. 1. Spontaneous Pneumothorax By: Dr. Ismah Reference: Management of spontaneous pneumothorax, British Thoracic Society pleural disease guideline 2010 06/08/2014 1
  2. 2. 06/08/2014 2
  3. 3. 06/08/2014 3
  4. 4. 06/08/2014 4
  5. 5. 06/08/2014 5
  6. 6. 06/08/2014 6
  7. 7. Suction • Not routinely used because may cause re expansion pulmonary edema • Indicated when persistent air leak with or without incomplete re-expansion of the lung after 48 hrs • High-volume low-pressure systems such as Vernon-Thompson pumps or wall suction with low pressure adaptors 06/08/2014 7
  8. 8. Bronchopleural fistula • Communication between the bronchial tree and pleural space. • Persistent air leak or a failure to re-inflate the lung despite chest tube drainage for 24 h. • Chest drains inserted into the lung parenchyma • Management: - Large bore chest drains (multiple if necessary) and the use of drainage system - Refractory cases  surgical repair of the air leak by thoracoplasty, lung resection/stapling, pleural abrasion/decortication 06/08/2014 8
  9. 9. Thoracic surgeon Indications for surgical advice: • Persistent air leak (despite 5 to 7 days of chest tube drainage) or failure of lung re-expansion. • Synchronous bilateral spontaneous pneumothorax. • Professions at risk (eg, pilots, divers). • Pregnancy. • Second ipsilateral pneumothorax. • First contralateral pneumothorax. • Spontaneous haemothorax 06/08/2014 9
  10. 10. Advice & f/up • Avoid air travel until 1 weeks post fully resolution • Avoid diving unless has undergone bilateral surgical pleurectomy and has normal lung function and chest CT scan postoperatively • Observation/ NA  F/up in 2-4 weeks 06/08/2014 10
  11. 11. THANK YOU 06/08/2014 11
  12. 12. Tension Pneumothorax 06/08/2014 12
  13. 13. 06/08/2014 13
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