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Pneumothorax

    • pneumothorax without an inciting event in a person without known pulmonary issues (
    • Epidemiology: 7/100000 in the United States
    • Risk factors: Smoking, family history, Marfan’s, homocysteinuria
    • Clinical Presentation:
      • Non-exertional usually in a 20 year old male
      • Sudden onset dyspnea and Pleuritic chest pain
  • PE: decreased chest excursion on the affected side, decreased breath sounds, hyperresonant percussion
  • Imaging:

pneumo1

  • white visceral pleural line demarcating the deflation of the lung and separation of the lung from the pleural air.
  • Treatment
    • Small pneumothoraxes <2 to 3cm = observation is OK
    • Medium pneumothorax >3cm or symptomatic = needle aspiration or chest tube insertion with pleurodesis if aspiration fails.
    • If chest tube is delayed or the patient is unstable, go with a 14 gauge cath needle to the 2nd ICS midclavicular or

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