![]() ![]() Subcutaneous emphysema and pneumomediastinum may also be presentĭescribed methods for estimating the percentage volume of pneumothorax from an erect PA radiograph include:Ī is the maximum apical interpleural distanceī is the interpleural distance at midpoint of upper half of lungĬ is the interpleural distance at midpoint of lower half of lung Mediastinum should not shift away from the pneumothorax unless a tension pneumothorax is present (discussed separately) Peripheral space is radiolucent compared to the adjacent lung No lung markings are seen peripheral to this line ![]() Visible visceral pleural edge is seen as a very thin, sharp white line Interlobar pneumothorax / interfissural pneumothorax 17 - form of loculated pneumothorax confined to the fissuresĪ pneumothorax is, when looked for, usually easily appreciated on erect chest radiographs. Pneumoperitoneum with passage through congenital/acquired diaphragmatic defectsīuffalo pneumothorax is the presence of bilateral pneumothoraces due to abnormal communication between the pleural spaces Radiofrequency (RF) ablation of lung massĬentral venous catheter insertion, nasogastric tube placement Rarely pleuroparenchymal fibroelastosis 9 Lung abscess, necrotic pneumonia, septic emboli, fungal disease, tuberculosisĬavitating neoplasm, metastatic osteogenic sarcomaĬatamenial pneumothorax 2,4: recurrent spontaneous pneumothorax during menstruation, associated with endometriosis of pleura Honeycombing: end-stage interstitial lung diseaseĭue to apical lung changes from ankylosing spondylitis 1 There are many pulmonary diseases which predispose to pneumothorax including: When the underlying lung is abnormal, a pneumothorax is referred to as secondary spontaneous. There may be a familial component, and there are well-known associations 10: Secondary spontaneous: underlying lung disease is presentĪ primary spontaneous pneumothorax occurs in a patient with no known underlying lung disease. Tall and thin habitus are more likely to develop a primary spontaneous pneumothorax. Primary spontaneous: no underlying lung disease It is useful to divide pneumothoraces into three categories 4: Secondary spontaneous: pleuritic chest pain often absent, dyspnea usually severe Primary spontaneous: pleuritic chest pain usually present, dyspnea mild or moderate It is interesting to note that some generalizations can be made regarding the clinical presentation in primary versus secondary spontaneous pneumothoraces: Presentation is variable and may range from no symptoms to severe dyspnea with tachycardia and hypotension. In patients with a tension pneumothorax, presentation may include distended neck veins and tracheal deviation, cardiac arrest, and death in the most severe cases. ![]()
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