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Pneumothorax
Air in the pleural cavity (outside the lungs)
- primary or secondary
- spontaneous or traumatic
Symptoms
- sudden onset
- pain
- tightness
- aggravated by deep breathing
Signs
- Chest expansion reduced or absent
- Percussion note hyper-resonant
- Breath sounds diminished / absent
- Vocal resonance reduced / absent
- mediastinum displaced away
- ? tinkling crepitations if some fluid present
Investigations
- CXR
- absent lung markings
- pleural border
- ABG
- reduced pO2
- increased pCO2
Treatment
- Aspirate
- 2nd intercostal space in the midclavicular line
- chest drain
- if reforms after aspiration
- 4,5, or 6th intercostal space in mid-axillary line
- pleurodesis / pleurectomy
- obliterates pleural space to prevent reformaing
- tetracycline pleurodesis v. v. painful
Prognosis
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