Secondary spontaneous pneumothorax
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Medpedia on Secondary spontaneous pneumothorax (Less technical, good quality control)
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See pneumothorax for context. Its importance is its higher likelihood of being life threatening[1].
Contents |
Aetiology
- COPD 260/million/year
- Histiocytosis X
- Cystic fibrosis
- Bronchial asthma
- Thoracic endometriosis - Catamenial pneumothorax
- Pregnancy - most common during labour
- HIV especially PCP (Pneumocystis carnii pneumonia)
- Pneumonia (particularily necrotising)
- Sarcoid
- Crytogenic pulmonary fibrosis
- Langerhan's-cell granulomatosis
- Lymphangioleiomyomatosis
- Tuberous sclerosis
- Rheumatoid arthritis
- Anklylosing spondylitis
- Polymyositis
- Dermatomyositis
- Scleroderma
- Marfan's syndrome
- Ehlers-Danlos syndrome
- Sarcoma
- Lung cancer
Incidence
Risk factors
- Smoking
- Tall - not as important as in primary spontaneous pneumothorax.
- Male 3.2:1 female
Management
Should be more aggressive than primary spontaneous pneumothorax as
- Poor pulmonary reserve
- High reoccurance rate
- Admit and observe for 24 hours after lung expanded- see Americian guidelines[4] and European guidelines[5]
- Observe if only very small and very stable patient
- Otherwise chest drain ...larger bore for larger pneumothoraces
- Consider (graded) talc pleurodesis on even first presentation
References
- ↑ Sahn SA, Heffner JE. Spontaneous pneumothorax. N Engl J Med. 2000 23;342(12):868-74.
- ↑ Melton LJ 3rd, Hepper NG, Offord KP. Incidence of spontaneous pneumothorax in Olmsted County, Minnesota: 1950 to 1974. Am Rev Respir Dis. 1979;120(6):1379-82
- ↑ Melton LJ 3rd, Hepper NG, Offord KP. Incidence of spontaneous pneumothorax in Olmsted County, Minnesota: 1950 to 1974. Am Rev Respir Dis. 1979;120(6):1379-82
- ↑ Baumann MH, Strange C, Heffner JE, Light R, Kirby TJ, Klein J, Luketich JD, Panacek EA, Sahn SA; AACP Pneumothorax Consensus Group. Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest. 2001;119(2):590-602.
- ↑ Henry M, Arnold T, Harvey J; Pleural Diseases Group, Standards of Care Committee, British Thoracic Society. BTS guidelines for the management of spontaneous pneumothorax. Thorax. 2003 May;58 Suppl 2:ii39-52. free guideline
