1
|
Managing Spontaneous Pneumothorax. Ann Emerg Med 2022; 81:568-576. [PMID: 36328849 DOI: 10.1016/j.annemergmed.2022.08.447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 11/22/2022]
|
2
|
Liu Y, Cheng J, Xu J, Yu J, Zhao L, Zhao K, Chen B. Correlation between Sternal Slope Angle and Primary Spontaneous Pneumothorax in Young Males, a Propensity Score Match Analysis. Clin Anat 2020; 33:605-609. [PMID: 31444881 DOI: 10.1002/ca.23461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/28/2019] [Accepted: 08/17/2019] [Indexed: 02/05/2023]
Abstract
It is generally accepted that primary spontaneous pneumothorax (PSP) is found mostly in tall, thin young males. However, the precise etiology of PSP is unclear. We compared some thoracic structural angles of PSPs and controls in young males to determine the predominant factor. CT data of 43 male PSPs (age 21.88 ± 5.30) and 30 controls (age 21.47 ± 5.47) were collected. The angle of thoracic vertebrae slope (∠α), sternal slope angle (∠β), and tracheal-sternal stem angle (∠γ) were measured in the sagittal position. Carina angle (∠δ) was measured in the coronal position. After a propensity score match (PSM) of age and smoking history, the angles were comparatively evaluated. There were significant differences in all four angles between two unmatched groups, while only in three (∠β, ∠γ, and ∠δ) after PSM was performed. The correlation between ∠β and PSP was most significant, and R2 was 0.456. The prediction accuracy of ∠β was 81.3%, OR was 1.386, 95% confidence interval was (1.095-1.754). The sternal slope angles in PSPs are greater than controls indicate the sternal slope angle is associates with the development of PSP and it could be a thoracic structural index to predict the risk of PSP occurrence. Clin. Anat. 33:605-609, 2020. © 2019 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Yong Liu
- Department of thoracic surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Cheng
- Department of thoracic surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiahang Xu
- Department of thoracic surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junjie Yu
- Department of thoracic surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liang Zhao
- Department of thoracic surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ke Zhao
- Department of thoracic surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Baojun Chen
- Department of thoracic surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
3
|
Habibi B, Achachi L, Hayoun S, Raoufi M, Herrak L, Ftouh ME. [Management of spontaneous pneumothorax: about 138 cases]. Pan Afr Med J 2017; 26:152. [PMID: 28533875 PMCID: PMC5429453 DOI: 10.11604/pamj.2017.26.152.11437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 02/18/2017] [Indexed: 11/29/2022] Open
Abstract
Pneumothorax is a collection of air in the pleural cavity. We conducted a retrospective study of patients with spontaneous pneumothorax in the Department of Pneumology at the Ibn Sina Hospital in Rabat (2009-2011) with the aim to determine the epidemiological, clinical, radiological, therapeutic and evolutionary manifestation of spontaneous pneumothorax. The study involved 138 patients: 128 men and 10 women (17-83 years), with an average age of 44.5 +/- 17.4 years and sex ratio of 12/8. 81.2% of patients were smokers. Clinical symptomatology was chest pain (92%), dyspnea (60%). Chest radiograph showed total unilateral (110 cases); partial (10 cases); localized (6 cases); bilateral (4 cases); right (51.4%) or left (45.7%) PNO (pneumothorax). During our study period we found that 70% of patients had spontaneous primitive pneumothorax and 30% had PNO secondary to Chronic obstructive pulmonary disease (COPD) (44%) and pulmonary tuberculosis (TB) (39%). Initial management included patients hospitalization, chest drainage (95%), needle exsufflation (1%), rest and O2 (4%). It enables the lung to stick to the chest wall within 10 days in 63% of patients. Evolution was favorable in 89% of patients. Immediate complications included: subcutaneous emphysema (5 cases); infection (6 cases) and 3 deaths (cardiorespiratory arrest). Late complications included: recurrences in 11.6%; the first recurrence occurred in 13 cases (chest drainage in 11 cases and oxygen therapy in 2 cases) while the second recurrence occurred in 3 cases (surgery). This study shows the role of chest drainage and monitoring in the management of pneumothorax to avoid complications and especially to prevent recurrences, with a possible need to resort to surgery.
Collapse
Affiliation(s)
| | | | | | | | - Laila Herrak
- Service de Pneumologie, CHU Ibn Sina, Rabat, Maroc
| | | |
Collapse
|
4
|
Roncati L, Pusiol T, Piscioli F, Scialpi M, Barbolini G, Maiorana A. Pneumothorax-associated fibroblastic lesion in combination with localized pleural angiomatosis: A possible cause of juvenile spontaneous hemopneumothorax. Pathol Res Pract 2015; 211:481-4. [PMID: 25749626 DOI: 10.1016/j.prp.2015.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 01/22/2015] [Accepted: 02/04/2015] [Indexed: 10/24/2022]
Abstract
Spontaneous hemopneumothorax is an uncommon but potentially life-threatening condition, with a potential for a rapid ventilatory collapse and a large collection of hidden blood loss into the pleural cavity. Here, we report the first case in the literature on pneumothorax-associated fibroblastic lesion in combination with localized pleural angiomatosis in a 19-year-old Caucasian male, resulting in massive spontaneous hemopneumothorax and hypovolemic shock. Our findings support a causal link between this condition and pneumothorax. The possible superimposed hemothorax is explainable by the pleural involvement of large angiomatous vessels, prone to rupture.
Collapse
Affiliation(s)
- Luca Roncati
- Department of Diagnostic and Clinical Medicine and of Public Health, Section of Pathology, University of Modena and Reggio Emilia, Modena, MO, Italy.
| | - Teresa Pusiol
- Provincial Health Care Services, Institute of Pathology, Santa Maria del Carmine Hospital, Rovereto, TN, Italy
| | - Francesco Piscioli
- Provincial Health Care Services, Institute of Pathology, Santa Maria del Carmine Hospital, Rovereto, TN, Italy
| | - Michele Scialpi
- Department of Surgical and Biomedical Sciences, Section of Radiology, University of Perugia, Perugia, PG, Italy
| | - Giuseppe Barbolini
- Department of Diagnostic and Clinical Medicine and of Public Health, Section of Pathology, University of Modena and Reggio Emilia, Modena, MO, Italy
| | - Antonio Maiorana
- Department of Diagnostic and Clinical Medicine and of Public Health, Section of Pathology, University of Modena and Reggio Emilia, Modena, MO, Italy
| |
Collapse
|
5
|
Chang PY, Wong KS, Lai JY, Chen JC, Chin TW, Chen KC, Wang CJ, Chang CJ, Hsu WM, Wang NL. Rapid increase in the height and width of the upper chest in adolescents with primary spontaneous pneumothorax. Pediatr Neonatol 2015; 56:53-7. [PMID: 25219870 DOI: 10.1016/j.pedneo.2014.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 06/30/2014] [Accepted: 07/28/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND We determined the chest height in a cohort of patients with primary spontaneous pneumothorax (PSP) who had received chest radiographic examinations prior to the attack. The aim of this study was to determine when their chest height began to change and how this was related to the PSP. METHODS From June 2009 to February 2012, the chest posteroanterior radiographs of 156 patients with PSP (Group 1) were reviewed. Among another 3134 patients with PSP, we identified 52 patients who had a chest posteroanterior radiograph prior to the attack (Group 2). We also recruited 196 controls for comparison (Group 3). The chest height and chest width at different levels were measured and analyzed. RESULTS Before 14 years of age, the chest height of patients in Group 2 was no different from that of patients in Group 3. By the age of 14 years, however, the chest height and upper chest width of patients with PSP was significantly higher than that of the normal controls. The difference from normal chest height did not increase at adulthood. CONCLUSION The rapid increase in chest height and upper chest width is a unique finding in patients with PSP. It might be attributable to the occurrence of PSP. This finding may also help to identify patients who are at risk of PSP.
Collapse
Affiliation(s)
- Pei-Yeh Chang
- Division of Pediatric Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan.
| | - Kin-Sun Wong
- Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Jin-Yao Lai
- Division of Pediatric Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Jeng-Chang Chen
- Division of Pediatric Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Tai-Wai Chin
- Department of Pediatric Surgery, Veteran General Hospital, Taipei, Taiwan
| | - Ke-Chi Chen
- Division of Pediatric Surgery, Department of Surgery, Tri-Service General Hospital, Taipei, Taiwan
| | - Chao-Jan Wang
- Department of Radiology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Chee-Jen Chang
- Chang Gung Memorial Hospital, Resources Center for Clinical Research, Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Ming Hsu
- Division of Pediatric Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Nien-Lu Wang
- Department of Pediatric Surgery Mackay Memorial Hospital, Taipei, Taiwan
| |
Collapse
|
6
|
Lin FCF, Chou MC, Jeng KC, Tsai SCS. Vascular-penetration defect detected in parietal pleura of primary spontaneous pneumothorax. Interact Cardiovasc Thorac Surg 2014; 19:861-3. [DOI: 10.1093/icvts/ivu229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|