Spontaneous Pneumothorax Spontaneous pneumothorax can be classified as either primary or secondary. Each type of spontaneous pneumothorax has a particular pathology and incidence that, in each case, leads to a particular way of treatment and monitoring. In general, a pneumothorax occurs when there is air present in the pleural cavity of the lung, however the underlying cause of this pathology varies among the different classifications. Surgical or non-surgical approaches are taken, depending on the severity or type of the pneumothorax. The purpose of this paper will be to discuss and distinguish between the pathology, incidence and medical treatment of a primary or secondary spontaneous pneumothorax. In general, a pneumothorax develops when
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PSPs are generally seen in males that are 10-30 years old, and are rarely seen in people over the age of 40. Unlike PSPs, the peak age of incidence of SSPs occurs based on the underlying lung disease the patient also have. Commonly, SSPs are not seen until later in life. For example, the peak age of SSP in patients with emphysema is seen between 60 and …show more content…
Patients with small PSP generally require only bed rest, observation and possible supplemental oxygen.4 In these cases, chest tubes are generally contraindicated unless the pneumothorax enlarges.5 As the PSP expands, a chest tube or simple aspiration is needed. Chest tubes are necessary in large pneumothorax and simple aspiration in most effective in small to moderately sized pneumothoraces.4 A chest tube is used to re-expand the effected lung by attaching to the Heimlich vale and remains in place until the lung is properly inflated.5 The chest tube is effective “in about 85%-90% of patients on the first episode of PSPs,” however the use of a chest tube increases the chance of recurrance.4 Surgical interventions are generally not considered until the second episode of PSP. The preferred innervation is the thoracoscopy or VATS (video-assisted thoracoscopic surgery).4,5 The goal of the surgery is “resection of blebs or the suture of apical perforation to treat the underlying defect” or “create a pleural symphysis to prevent recurrence.”4 The management of SPS is very similar to SSP in regards to the severity, however greater care should be taken due to the possibility of a medical emergency.3,5 Most notably, surgical interventions are considered after the first episode due to the presence of
PSPs are generally seen in males that are 10-30 years old, and are rarely seen in people over the age of 40. Unlike PSPs, the peak age of incidence of SSPs occurs based on the underlying lung disease the patient also have. Commonly, SSPs are not seen until later in life. For example, the peak age of SSP in patients with emphysema is seen between 60 and …show more content…
Patients with small PSP generally require only bed rest, observation and possible supplemental oxygen.4 In these cases, chest tubes are generally contraindicated unless the pneumothorax enlarges.5 As the PSP expands, a chest tube or simple aspiration is needed. Chest tubes are necessary in large pneumothorax and simple aspiration in most effective in small to moderately sized pneumothoraces.4 A chest tube is used to re-expand the effected lung by attaching to the Heimlich vale and remains in place until the lung is properly inflated.5 The chest tube is effective “in about 85%-90% of patients on the first episode of PSPs,” however the use of a chest tube increases the chance of recurrance.4 Surgical interventions are generally not considered until the second episode of PSP. The preferred innervation is the thoracoscopy or VATS (video-assisted thoracoscopic surgery).4,5 The goal of the surgery is “resection of blebs or the suture of apical perforation to treat the underlying defect” or “create a pleural symphysis to prevent recurrence.”4 The management of SPS is very similar to SSP in regards to the severity, however greater care should be taken due to the possibility of a medical emergency.3,5 Most notably, surgical interventions are considered after the first episode due to the presence of