Pneumothorax is a common presentation to the emergency department, arising from traumatic and non-traumatic aetiologies. [ncbi.nlm.nih.gov]

This case highlights a unique presentation of pneumothorax in a healthy young individual. [omicsonline.org]

When bullous disease is present, a loculated pneumothorax may appear similar. [radiopaedia.org]

Case report We present the case of a 22 year old man who was admitted to the emergency department after a motorcycle accident having a painless crepitant scrotum and chest excoriations. [link.springer.com]

However, these findings are not always present and may be hard to detect in a noisy resuscitation setting. [merckmanuals.com]

• Pain

  Patients who required emergency tube placement, those who refused and those who could not respond to pain assessment were excluded. Primary outcomes were tube-site pain, as assessed by a numerical rating scale, and total pain medication use. [ncbi.nlm.nih.gov]

  People have chest pain. Most of the pain is due to the injury that caused the pneumothorax. They may feel short of breath or breathe rapidly and feel that their heart is racing, particularly if the amount of air is large. [msdmanuals.com]

  An athlete who has suffered only a rib fracture will report pain in the area and an increase of this pain with inspiration due to the movement of the rib. [healio.com]

• Collapse

  X-rays The left lung – collapsed and pressing on the surrounding structures. [ukessays.com]

  The purpose of this research is to see if people who have had a collapsed lung that has been re-expanded can be safely taken to an elevation that a person might experience while in a commercial airplane without having their lung partially collapse again [clinicaltrials.gov]

  Blood and air that enter the pleural space can cause the lung to collapse. What causes collapsed lung? There are many causes of collapsed lung. They are associated with the type of collapsed lung. [my.clevelandclinic.org]

  Complete collapse of affected lung with increased pressure in chest resulting in mediastinal shift and impaired venous return to heart. Ventilation and circulation is compromised. [quizlet.com]

• Falling

  The mechanism of parachute landing fall could account for the low incidence of pneumothorax among paratroopers [ 16 ]. [omicsonline.org]

  A 33-year-old woman presented to our ED complaining of right knee and right lateral chest wall pain after falling. Her breath sounds were reported as normal. [ncbi.nlm.nih.gov]

  Pneumothorax may result when blunt force (such as a motor vehicle crash or fall) or a penetrating injury (such as a stab or gunshot wound) damages the lungs and/or airways. [msdmanuals.com]

  Chest tubes could be painful, become kinked or clogged, or could fall out or leak. Chest tubes could also cause a lung infection, or fluid could fill the lung instead of air. [drugs.com]

• Asymptomatic

  Two patients subsequently had chest drains inserted as a result of asymptomatic radiological enlargement of the pneumothorax while inpatients. No patients deteriorated clinically during conservative treatment. [ncbi.nlm.nih.gov]

  Four of these 33 patients subsequently had chest drain applica- tion because of asymptomatic enlargement of the pneumothorax size on chest radiography during the follow up period. [scopemed.org]

  A small pneumothorax may be asymptomatic, whereas large pneumothorax may present with acute chest pain, dyspnea, chest tightness, cough, back pain, and ipsilateral shoulder pain. [prccm.org]

• Surgical Procedure

  Sarcoidosis Positive pressure ventilation Connective tissue diseases Central venous catheterization Idiopathic pulmonary fibrosis Surgical procedures in the thorax, Marfan’s syndrome or lower neck Lung cancer Tracheostomy Sarcoma Thoracoscopy/laparoscopy [academic.oup.com]

  /-procedural complications Persistent fistula with continuous air leak Injury to intercostal nerves and vessels Infection References: [1] We list the most important complications. [amboss.com]

  Both surgical and nonsurgical treatments are available. Treatment options can include close observation combined with the insertion of chest tubes, or more invasive surgical procedures to resolve and prevent further collapse of the lung. [healthline.com]

  Because the technical approach to the surgical procedure is rarely taught in France (and consequently rarely practiced), all participants (including senior physicians) received a one-hour academic lesson, prior to the simulation session, on surgical chest [omicsonline.org]

  World Journal of Surgical Oncology, 7, 57. [ukessays.com]

• Dyspnea

  However, the clinical findings in this case did not have the typical presentation of a sudden onset of dyspnea or decreased oxygen saturation [ 5 ]. [omicsonline.org]

  Rupture of bleb (blisters) on lung in COPD or Congenital (present from birth -Dyspnea (labored breathing) -Dry hacking cough -Asymmetric chest movement -Diminished or absent BS over affected side -Hyperresonance on percussion -Subcutaneous Emphysema [quizlet.com]

  Symptoms include chest pain from the causative injury and sometimes dyspnea. Diagnosis is made by chest x-ray. Treatment is usually with tube thoracostomy. [merckmanuals.com]

• Pleural Effusion

  […] tumor (Medical Encyclopedia) Pleural effusion (Medical Encyclopedia) Pleurisy (Medical Encyclopedia) [ Read More ] [icdlist.com]

  Resources: BTS Pleural Disease Guidelines 2010: Management of spontaneous pneumothorax BTS Pleural Disease Guidelines 2010: Complete includes information on: investigation of a unilateral pleural effusion in adults management of spontaneous pneumothorax [scghed.com]

  PLEURAL EFFUSION Fluid in the pleural space is called pleural effusion. The fluid may be lymph (chylothorax), pus (empyema), blood (hemothorax), or non-specific serous fluid. [teleflex.com]

  Most common CXR finding was pleural effusion; most common operative finding was pleural rind. [east.org]

  Diagnostic accuracy of sonography for pleural effusion: systematic review. Sao Paulo Med J. 2010;128(2):90-5. Ma OJ, Mateer JR, Scalea TM, Sclafani SJA. Trauma ultrasound examination versus chest radiography in the detection of hemothorax. [ijsurgery.com]

• Decreased Breath Sounds

  The symptoms of a pneumothorax may include: dull, sharp or stabbing chest pain that becomes worse with breathing or coughing, shortness of breath, rapid breathing, abnormal breathing movement, anxiety, weak pulse, decreased breath sounds on the affected [traumasurvivorsnetwork.org]

  […] chest movement Tracheal deviation to the contra-lateral side Hyper-resonance ipsilaterally Decreased breath sounds ipsilaterally Bedside ultrasound can rapidly confirm pneumothorax Management High flow oxygen to maintain SpO2 target (e.g. 15L/min via [litfl.com]

  Listening to the chest with a stethoscope may reveal decreased breath sounds on one side of the chest. There may be a bluish coloration of the skin caused by lack of oxygen. The affected person may have a rapid heart rate. [lutheranaugustanacenter.com]

  On primary exam the resident notes diminished breath sounds on the right, however he asks the question to the rest of the trauma team: “are the decreased breath sounds from a pneumo/hemothorax or from a partially paralyzed/weakened diaphragm, in a patient [blogs.brown.edu]

• Hyperresonance

  On lung examination, hyperresonance to percussion, decreased tactile fremitus, and diminished breath sounds are present on the affected side. [journals.lww.com]

  Breath sounds may be diminished and the affected hemithorax hyperresonant to percussion—mainly with larger pneumothoraces. However, these findings are not always present and may be hard to detect in a noisy resuscitation setting. [merckmanuals.com]

  Rupture of bleb (blisters) on lung in COPD or Congenital (present from birth -Dyspnea (labored breathing) -Dry hacking cough -Asymmetric chest movement -Diminished or absent BS over affected side -Hyperresonance on percussion -Subcutaneous Emphysema [quizlet.com]

• Pleuritic Pain

  What to look for Whether traumatic, iatrogenic, or spontaneous, pneumothorax causes these cardinal signs and symptoms: sudden, sharp, pleuritic pain exacerbated by chest movement, breathing, and coughing asymmetric chest wall movement shortness of breath [journals.lww.com]

  Pain. Pain is usually sudden and may be pleuritic. Minimal respiratory distress. The patient may have only minimal respiratory distress with slight chest discomfort and tachypnea. Dyspnea. Due to pain, the patient has difficulty in breathing. [nurseslabs.com]

  Chest pain : a pleuritic pain may give a sensation of breathlessness. Examples include pleurodynia and Bornholm disease. Pulmonary embolism may produce haemoptysis and a few rales over the affected area. [patient.info]

• Chest Pain

  People have chest pain. Most of the pain is due to the injury that caused the pneumothorax. They may feel short of breath or breathe rapidly and feel that their heart is racing, particularly if the amount of air is large. [msdmanuals.com]

• Hypotension

  However, tension pneumothorax can cause severe hypotension, and open pneumothorax can compromise ventilation. [msdmanuals.com]

  Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 1994; 331:1105-1109. 4. Gross D, Landau EH, Assalia A, Krausz MM. [books.google.it]

  cool peripheries Beck’s triad: muffled heart sounds, hypotension and distended neck veins — not especially in a noisy trauma bay! [litfl.com]

  An unexplained tachycardia, hypotension and rise in airway pressure are strongly suggestive of a developing tension. [trauma.org]

  However, tension pneumothorax can cause severe hypotension, and open pneumothorax can compromise ventilation. Patients with traumatic pneumothorax commonly have pleuritic chest pain, dyspnea, tachypnea, and tachycardia. [merckmanuals.com]

• Cyanosis

  Atelectasis and Pneumothorax Lungs Pain Trouble breathing Faintness Cyanosis Mucus plug Tumor Inhaled foreign object Physical trauma to the lung Wound Overview Atelectasis and pneumothorax are conditions in which the lung or part of the lung collapses [nm.org]

  Central cyanosis. The patient may develop central cyanosis from severe hypoxemia. Chest expansion. In simple and tension pneumothorax, the chest expansion is decreased. Breath sounds. [nurseslabs.com]

  In addition to chest pain and breathing difficulties, its symptoms include tachycardia, cyanosis, distended blood vessels on the neck and hypotension. [ebm-guidelines.com]

  Cyanosis or blueness of the skin will occur as the tissues lose their oxygen. Decreased levels of consciousness may occur because of the low blood pressure, decreased brain perfusion, and low oxygenation. [emedicinehealth.com]

  Signs/symptoms of tension pneumothorax include: rapid, labored respirations; tachycardia; cyanosis; hypoxemia; and sudden chest pain that extends to the shoulders. [teleflex.com]

• Heart Failure

  The most common cause of pleural effusion is congestive heart failure. Lung diseases, like COPD, tuberculosis, and acute lung injury, cause pneumothorax. Injury to the chest is the most common cause of hemothorax. [icdlist.com]

  Iatrogenic pneumothorax can be mimicked by pulmonary embolism, pneumonia, and congestive heart failure. [cancertherapyadvisor.com]

  Admit patients with arrhythmias or heart failure to level 3 ICU non-urgent surgery should be postponed where possible because of life threatening operative complications. [aic.cuhk.edu.hk]

  […] using ATOM-FC: Aortic injury Thorax injuries (non-massive hemothorax, simple pneumothorax) Oesphageal perforation Muscular diaphragmatic injury (a stretch this one, I know) Fistula (bronchopleural) and other tracheobronchial injury Contusion to the heart [litfl.com]

• Atelectasis

  Atelectasis and Pneumothorax Lungs Pain Trouble breathing Faintness Cyanosis Mucus plug Tumor Inhaled foreign object Physical trauma to the lung Wound Overview Atelectasis and pneumothorax are conditions in which the lung or part of the lung collapses [nm.org]

  Definition / general All types may cause compression, collapse, atelectasis of lung and associated respiratory distress Either spontaneous, traumatic or therapeutic Spontaneous: due to abscess, tuberculosis, emphysema, asthma Traumatic: due to puncture [pathologyoutlines.com]

  Not necessarily due to progression of contusion but is more often due to development of pneumothorax, haemothorax, atelectasis or pulmonary oedema. [aic.cuhk.edu.hk]

  Decreased chest-wall movement and bad respiratory hygiene can cause atelectasis and pneumonia or the development of an infection. [intechopen.com]

  Things that may cause false positives, especially in non-trauma, critically ill patients: Dyspnea causes interference above the pleural line Single lung intubation, or esophageal intubation can lead to secondary atelectasis Lung and pleura adhering together [rebelem.com]

• Pleural Effusion

  […] tumor (Medical Encyclopedia) Pleural effusion (Medical Encyclopedia) Pleurisy (Medical Encyclopedia) [ Read More ] [icdlist.com]

  Resources: BTS Pleural Disease Guidelines 2010: Management of spontaneous pneumothorax BTS Pleural Disease Guidelines 2010: Complete includes information on: investigation of a unilateral pleural effusion in adults management of spontaneous pneumothorax [scghed.com]

  PLEURAL EFFUSION Fluid in the pleural space is called pleural effusion. The fluid may be lymph (chylothorax), pus (empyema), blood (hemothorax), or non-specific serous fluid. [teleflex.com]

  Most common CXR finding was pleural effusion; most common operative finding was pleural rind. [east.org]

  Diagnostic accuracy of sonography for pleural effusion: systematic review. Sao Paulo Med J. 2010;128(2):90-5. Ma OJ, Mateer JR, Scalea TM, Sclafani SJA. Trauma ultrasound examination versus chest radiography in the detection of hemothorax. [ijsurgery.com]

[…] was to retrospectively review a series of consecutive patients treated for chest trauma between 1 January 2000 and 31 December 2005, focusing particularly on cases of pneumothorax and hemothorax. alone or in combination, and to critically assess the treatment [ncbi.nlm.nih.gov]

However, there are usually no long-term effects after successful treatment for a pneumothorax. Call your health care provider if symptoms come back after treatment of a traumatic pneumothorax. If untreated, tension pneumothorax can develop. [lutheranaugustanacenter.com]

Treatment will depend on the size of your pneumothorax. If your pneumothorax is small, it may resolve on its own. The goal of treatment is to remove the air from your pleural space. [drugs.com]

The prognosis for traumatic pneumothorax is excellent if there are no other life-threatening injuries; for spontaneous pneumothorax, the prognosis depends on the underlying cause and method of treatment. [ncbi.nlm.nih.gov]

Prognosis If the pneumothorax was an isolated event and treatment was initiated early, the prognosis is excellent. The rate of recurrence of a simple spontaneous pneumothorax can be as high as 30% ipsilateral and 10% contralateral. [emedicine.medscape.com]

The numerical size is valuable mainly for quantifying progression and resolution rather than for determining prognosis. [merckmanuals.com]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

The emergency department (ED) treatment of pneumothoraces depends on their size, their etiology, and clinical stability of the patient. [ncbi.nlm.nih.gov]

While ruptured blebs have been determined as an etiology of pneumothorax in otherwise healthy young male military service members, a more common etiology of pneumothorax among service members results from blunt trauma, usually secondary to a rib fracture [omicsonline.org]

Discussion Subcutaneous emphysema of the scrotum – especially of traumatic etiology – is not a common medical condition. Causes that may result in the presence of air in the scrotum are: 1. [link.springer.com]

[…] pneumothorax occurs as a complication of underlying lung disease Tension pneumothorax : : life-threatening variant of pneumothorax characterized by progressively increasing pressures within the chest and cardiorespiratory compromise References: [1] Etiology [amboss.com]

CONCLUSION There is evidence of two epidemiologically distinct forms of spontaneous pneumothorax in England. [thorax.bmj.com]

Epidemiology Primary spontaneous pneumothorax Sex : ♂ > ♀ ( approx. 6:1 ) Peak incidence : 20–3 0 years Secondary spontaneous pneumothorax Sex : ♂ > ♀ ( approx. 3:1 ) Peak incidence : 60–65 years References: [1] Epidemiological data refers to the US, [amboss.com]

INTRODUCTION AND EPIDEMIOLOGY Pneumothorax occurs when free air enters the potential space between the visceral and parietal pleura. [accessmedicine.mhmedical.com]

A prospective, population-based study of the demographics, epidemiology, management, and outcome of out-of-hospital pediatric cardiopulmonary arrest. Ann Emerg Med. ‎ [books.google.it]

Applicants with an FEV1/FVC ratio of less than 70 % should be evaluated by a specialist in respiratory disease. ( 2) Chest radiography Posterior/anterior chest radiography may be required at initial, revalidation or renewal examinations if clinically or epidemiologically [caa.co.uk]

One of the top-selling titles from the Incredibly Easy series, the fully updated 5th edition of Pathophysiology Made Incredibly Easy presents information vital to nurses and student nurses on the difficult topic of pathophysiology in an easy-to-learn, [books.google.de]

Pathophysiology: Clinical Concepts of Disease Processes. St Louis, Mo: Mosby; 1997:409-431. [healio.com]

Source Excerpted and adapted from Pathophysiology Made Incredibly Easy ! 2nd edition, Lippincott Williams & Wilkins, 2002. © 2002 Lippincott Williams & Wilkins, Inc. [journals.lww.com]

Pathophysiology The pathophysiology of pneumothorax include: Negative pressure. The negative pressure is required to maintain lung inflation. Breach. When either pleura is breached, air enters the pleural space. Collapse. [nurseslabs.com]

Patient Education Pathophysiology Spontaneous pneumothorax occurs via rupture of the visceral pleura, whereas traumatic pneumothorax may occur following injury to either pleural layer. [emedicine.medscape.com]

BACKGROUND: Pneumothorax is one of the leading causes of preventable death in trauma patients. Chest radiograph has a lower sensitivity than a computed tomography (CT) scan for the diagnosis of pneumothorax. [ncbi.nlm.nih.gov]

[…] cancer) Traumatic Pneumothorax (a result of blunt or penetrating trauma to the chest wall, secondary to surgery or other medical procedures, or as a consequence of sudden decompression at high altitude) Resolution of air from the pleural cavity and prevention [casa.gov.au]

SELF CONTAINED ONE WAY VALVE AND VENT: Prevents air and fluid from returning to the pleural space, whilst allowing air to escape the unit, but keeping fluid contained ready for safe drainage. [sales.rocketmedical.com]

The trapped air prevents the lung from re-inflating. Pneumothorax can occur as a result of a blow to the chest, such as from a fall or car accident (blunt trauma). It can happen with or without a broken rib. [fairview.org]