Pneumothorax: How to interpret the diagnostic clues

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Consider primary spontaneous pneumothorax in an otherwise healthy person with acute chest pain and dyspnea if the affected side of the chest is enlarged, moves less during respiration, and is hyperresonant on percussion; tactile fremitus is absent; and breath sounds are reduced or absent. On a standard inspiratory chest film, a thin pleural line that usually parallels the chest wall is diagnostic of pneumothorax. When in doubt, obtain expiratory or lateral decubitus films. Suspect secondary spontaneous pneumothorax in a patient with chronic obstructive pulmonary disease or cystic fibrosis who has increased dyspnea and unilateral chest pain. Percutaneous lung aspiration, thoracentesis, bronchoscopy with transbronchial biopsy, Swan-Ganz catheterization, and mechanical ventilation can cause traumatic pneumothorax. Tension pneumothorax may follow; the clinical signs are severe tachycardia and tachypnea with profuse diaphoresis.

Original languageEnglish (US)
Pages (from-to)1934-1945
Number of pages12
Issue number8
StatePublished - Aug 1 1998

ASJC Scopus subject areas

  • Medicine(all)


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