Abstract
Pneumothorax, defined as air in the pleural space, can occur from various etiologies. Primary spontaneous pneumothorax (PSP) occurs in patients without lung disease. Secondary spontaneous pneumothorax occurs in patients with underlying lung disease. Nonspontaneous pneumothorax includes traumatic and iatrogenic. The clinical presentation of pneumothorax can vary although dyspnea, tachycardia, and chest pain are common symptoms. Upright chest x-ray has long been the gold standard for diagnostic testing however bedside ultrasound especially in the ICU has been proven to be a more sensitive and specific test. Stable patients with a first primary spontaneous small pneumothorax (≤3 cm) may be treated conservatively with supplemental oxygen. In a large, symptomatic, tension type, or recurrent pneumothorax, the pleural air should be removed. This can be accomplished by simple needle aspiration or tube thoracostomy. Video assisted thoracostomy can be used along with mechanical or chemical pleurodesis to treat recurrent pneumothoraces along with bronchoplueral fistulas.
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