Pneumothorax Questions & Answers

1. Tschopp JM, Rami-Porta R, Noppen M, Astoul P. Management of spontaneous pneumothorax: state of the art. Eur Respir J. 2006 Sep. 28 (3):637-50. [QxMD MEDLINE Link].

2. Sahn SA, Heffner JE. Spontaneous pneumothorax. N Engl J Med. 2000 Mar 23. 342 (12):868-74. [QxMD MEDLINE Link].

3. Noppen M, Dekeukeleire T, Hanon S, Stratakos G, Amjadi K, Madsen P, et al. Fluorescein-enhanced autofluorescence thoracoscopy in patients with primary spontaneous pneumothorax and normal subjects. Am J Respir Crit Care Med. 2006 Jul 1. 174 (1):26-30. [QxMD MEDLINE Link].

4. Tabakoglu E, Ciftci S, Hatipoglu ON, Altiay G, Caglar T. Levels of superoxide dismutase and malondialdehyde in primary spontaneous pneumothorax. Mediators Inflamm. 2004 Jun. 13 (3):209-10. [QxMD MEDLINE Link].

5. Haraguchi S, Fukuda Y. Histogenesis of abnormal elastic fibers in blebs and bullae of patients with spontaneous pneumothorax: ultrastructural and immunohistochemical studies. Acta Pathol Jpn. 1993 Dec. 43 (12):709-22. [QxMD MEDLINE Link].

6. Gunji Y, Akiyoshi T, Sato T, Kurihara M, Tominaga S, Takahashi K, et al. Mutations of the Birt Hogg Dube gene in patients with multiple lung cysts and recurrent pneumothorax. J Med Genet. 2007 Sep. 44 (9):588-93. [QxMD MEDLINE Link].

7. Lal A, Anderson G, Cowen M, Lindow S, Arnold AG. Pneumothorax and pregnancy. Chest. 2007 Sep. 132 (3):1044-8. [QxMD MEDLINE Link].

8. Chiu HT, Garcia CK. Familial spontaneous pneumothorax. Curr Opin Pulm Med. 2006 Jul. 12 (4):268-72. [QxMD MEDLINE Link].

9. Feldman AL, Sullivan JT, Passero MA, Lewis DC. Pneumothorax in polysubstance-abusing marijuana and tobacco smokers: three cases. J Subst Abuse. 1993. 5 (2):183-6. [QxMD MEDLINE Link].

10. Sihoe AD, Wong RH, Lee AT, Lau LS, Leung NY, Law KI, et al. Severe acute respiratory syndrome complicated by spontaneous pneumothorax. Chest. 2004 Jun. 125 (6):2345-51. [QxMD MEDLINE Link].

11. Metersky ML, Colt HG, Olson LK, Shanks TG. AIDS-related spontaneous pneumothorax. Risk factors and treatment. Chest. 1995 Oct. 108 (4):946-51. [QxMD MEDLINE Link].

12. Flume PA, Strange C, Ye X, Ebeling M, Hulsey T, Clark LL. Pneumothorax in cystic fibrosis. Chest. 2005 Aug. 128 (2):720-8. [QxMD MEDLINE Link].

13. Leslie MD, Napier M, Glaser MG. Pneumothorax as a complication of tumour response to chemotherapy. Clin Oncol (R Coll Radiol). 1993. 5 (3):181-2. [QxMD MEDLINE Link].

14. Lee CC, Lee SH, Chang IJ, Lu TC, Yuan A, Chang TA, et al. Spontaneous pneumothorax associated with ankylosing spondylitis. Rheumatology (Oxford). 2005 Dec. 44 (12):1538-41. [QxMD MEDLINE Link].

15. Korom S, Canyurt H, Missbach A, Schneiter D, Kurrer MO, Haller U, et al. Catamenial pneumothorax revisited: clinical approach and systematic review of the literature. J Thorac Cardiovasc Surg. 2004 Oct. 128 (4):502-8. [QxMD MEDLINE Link].

16. Plewa MC, Ledrick D, Sferra JJ. Delayed tension pneumothorax complicating central venous catheterization and positive pressure ventilation. Am J Emerg Med. 1995 Sep. 13 (5):532-5. [QxMD MEDLINE Link].

17. de Lassence A, Timsit JF, Tafflet M, Azoulay E, Jamali S, Vincent F, et al. Pneumothorax in the intensive care unit: incidence, risk factors, and outcome. Anesthesiology. 2006 Jan. 104 (1):5-13. [QxMD MEDLINE Link].

18. Miller JS, Itani KM, Oza MD, Wall MJ. Gastric rupture with tension pneumoperitoneum: a complication of difficult endotracheal intubation. Ann Emerg Med. 1997 Sep. 30 (3):343-6. [QxMD MEDLINE Link].

19. Hashmi S, Rogers SO. Tension pneumothorax with pneumopericardium. J Trauma. 2003 Jun. 54 (6):1254. [QxMD MEDLINE Link].

20. Iannoli ED, Litman RS. Tension pneumothorax during flexible fiberoptic bronchoscopy in a newborn. Anesth Analg. 2002 Mar. 94 (3):512-3; table of contents. [QxMD MEDLINE Link]. [Full Text].

21. Peuker E. Case report of tension pneumothorax related to acupuncture. Acupunct Med. 2004 Mar. 22 (1):40-3. [QxMD MEDLINE Link]. [Full Text].

22. Whale C, Hallam C. Tension pneumothorax related to acupuncture. Acupunct Med. 2004 Jun. 22 (2):101; author reply 101-2. [QxMD MEDLINE Link].

23. Zhao DY, Zhang GL. [Clinical analysis on 38 cases of pneumothorax induced by acupuncture or acupoint injection]. Zhongguo Zhen Jiu. 2009 Mar. 29 (3):239-42. [QxMD MEDLINE Link].

24. Dalton AM, Hodgson RS, Crossley C. Bochdalek hernia masquerading as a tension pneumothorax. Emerg Med J. 2004 May. 21 (3):393-4. [QxMD MEDLINE Link]. [Full Text].

25. Hearnshaw SA, Oppong K, Jaques B, Thompson NP. Tension pneumothorax as a complication of colonoscopy. Endoscopy. 2004 Feb. 36 (2):190. [QxMD MEDLINE Link]. [Full Text].

26. Brander L, Takala J. Tracheal tear and tension pneumothorax complicating bronchoscopy-guided percutaneous tracheostomy. Heart Lung. 2006 Mar-Apr. 35 (2):144-5. [QxMD MEDLINE Link].

27. McPherson JJ, Feigin DS, Bellamy RF. Prevalence of tension pneumothorax in fatally wounded combat casualties. J Trauma. 2006 Mar. 60 (3):573-8. [QxMD MEDLINE Link].

28. Yamashita H, Tsukayama H, Tanno Y, Nishijo K. Adverse events related to acupuncture. JAMA. 1998 Nov 11. 280 (18):1563-4. [QxMD MEDLINE Link].

29. Melton LJ 3rd, Hepper NG, Offord KP. Incidence of spontaneous pneumothorax in Olmsted County, Minnesota: 1950 to 1974. Am Rev Respir Dis. 1979 Dec. 120 (6):1379-82. [QxMD MEDLINE Link].

30. Gupta D, Hansell A, Nichols T, Duong T, Ayres JG, Strachan D. Epidemiology of pneumothorax in England. Thorax. 2000 Aug. 55 (8):666-71. [QxMD MEDLINE Link].

31. Bense L, Eklund G, Wiman LG. Smoking and the increased risk of contracting spontaneous pneumothorax. Chest. 1987 Dec. 92 (6):1009-12. [QxMD MEDLINE Link].

32. Huang TW, Lee SC, Cheng YL, Tzao C, Hsu HH, Chang H, et al. Contralateral recurrence of primary spontaneous pneumothorax. Chest. 2007 Oct. 132 (4):1146-50. [QxMD MEDLINE Link].

33. Rezende-Neto JB, Hoffmann J, Al Mahroos M, Tien H, Hsee LC, Spencer Netto F, et al. Occult pneumomediastinum in blunt chest trauma: clinical significance. Injury. 2010 Jan. 41 (1):40-3. [QxMD MEDLINE Link].

34. [Guideline] British Thoracic Society Fitness to Dive Group, Subgroup of the British Thoracic Society Standards of Care Committee. British Thoracic Society guidelines on respiratory aspects of fitness for diving. Thorax. 2003 Jan. 58 (1):3-13. [QxMD MEDLINE Link]. [Full Text].

35. Rodriguez RM, Hendey GW, Marek G, Dery RA, Bjoring A. A pilot study to derive clinical variables for selective chest radiography in blunt trauma patients. Ann Emerg Med. 2006 May. 47 (5):415-8. [QxMD MEDLINE Link].

36. Lopes JA, Frankel HL, Bokhari SJ, Bank M, Tandon M, Rabinovici R. The trauma bay chest radiograph in stable blunt-trauma patients: do we really need it?. Am Surg. 2006 Jan. 72 (1):31-4. [QxMD MEDLINE Link].

37. Shatz DV, de la Pedraja J, Erbella J, Hameed M, Vail SJ. Efficacy of follow-up evaluation in penetrating thoracic injuries: 3- vs. 6-hour radiographs of the chest. J Emerg Med. 2001 Apr. 20 (3):281-4. [QxMD MEDLINE Link].

38. [Guideline] MacDuff A, Arnold A, Harvey J, BTS Pleural Disease Guideline Group. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010 Aug. 65 Suppl 2:ii18-31. [QxMD MEDLINE Link]. [Full Text].

39. Baumann MH, Strange C, Heffner JE, Light R, Kirby TJ, Klein J, et al. Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest. 2001 Feb. 119 (2):590-602. [QxMD MEDLINE Link].

40. Light RW, Lee YCG. Pneumothorax, chylothorax, hemothorax, and fibrothorax. Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia: Elsevier Saunders; 2016. Vol 2: 1439-60.

41. Ball CG, Kirkpatrick AW, Feliciano DV. The occult pneumothorax: what have we learned?. Can J Surg. 2009 Oct. 52 (5):E173-9. [QxMD MEDLINE Link]. [Full Text].

42. Barrios C, Tran T, Malinoski D, Lekawa M, Dolich M, Lush S, et al. Successful management of occult pneumothorax without tube thoracostomy despite positive pressure ventilation. Am Surg. 2008 Oct. 74 (10):958-61. [QxMD MEDLINE Link].

43. Shah K, Tran J, Schmidt L. Traumatic pneumothorax: updates in diagnosis and management in the emergency department. Emerg Med Pract. 2022 Apr 15. 25 (5, Suppl 1):1-28. [QxMD MEDLINE Link].

44. Busch M. Portable ultrasound in pre-hospital emergencies: a feasibility study. Acta Anaesthesiol Scand. 2006 Jul. 50 (6):754-8. [QxMD MEDLINE Link].

45. Zanobetti M, Poggioni C, Pini R. Can chest ultrasonography replace standard chest radiography for evaluation of acute dyspnea in the ED?. Chest. 2011 May. 139 (5):1140-1147. [QxMD MEDLINE Link].

46. Dente CJ, Ustin J, Feliciano DV, Rozycki GS, Wyrzykowski AD, Nicholas JM, et al. The accuracy of thoracic ultrasound for detection of pneumothorax is not sustained over time: a preliminary study. J Trauma. 2007 Jun. 62 (6):1384-9. [QxMD MEDLINE Link].

47. Knudtson JL, Dort JM, Helmer SD, Smith RS. Surgeon-performed ultrasound for pneumothorax in the trauma suite. J Trauma. 2004 Mar. 56 (3):527-30. [QxMD MEDLINE Link].

48. Dulchavsky SA, Schwarz KL, Kirkpatrick AW, Billica RD, Williams DR, Diebel LN, et al. Prospective evaluation of thoracic ultrasound in the detection of pneumothorax. J Trauma. 2001 Feb. 50 (2):201-5. [QxMD MEDLINE Link].

49. Brook OR, Beck-Razi N, Abadi S, Filatov J, Ilivitzki A, Litmanovich D, et al. Sonographic detection of pneumothorax by radiology residents as part of extended focused assessment with sonography for trauma. J Ultrasound Med. 2009 Jun. 28 (6):749-55. [QxMD MEDLINE Link].

50. Hernandez C, Shuler K, Hannan H, Sonyika C, Likourezos A, Marshall J. C.A.U.S.E.: Cardiac arrest ultra-sound exam--a better approach to managing patients in primary non-arrhythmogenic cardiac arrest. Resuscitation. 2008 Feb. 76 (2):198-206. [QxMD MEDLINE Link].

51. Sartori S, Tombesi P, Trevisani L, Nielsen I, Tassinari D, Abbasciano V. Accuracy of transthoracic sonography in detection of pneumothorax after sonographically guided lung biopsy: prospective comparison with chest radiography. AJR Am J Roentgenol. 2007 Jan. 188 (1):37-41. [QxMD MEDLINE Link].

52. Zhang M, Liu ZH, Yang JX, Gan JX, Xu SW, You XD, et al. Rapid detection of pneumothorax by ultrasonography in patients with multiple trauma. Crit Care. 2006. 10 (4):R112. [QxMD MEDLINE Link]. [Full Text].

53. Shostak E, Brylka D, Krepp J, Pua B, Sanders A. Bedside sonography for detection of postprocedure pneumothorax. J Ultrasound Med. 2013 Jun. 32 (6):1003-9. [QxMD MEDLINE Link].

54. Slater A, Goodwin M, Anderson KE, Gleeson FV. COPD can mimic the appearance of pneumothorax on thoracic ultrasound. Chest. 2006 Mar. 129 (3):545-50. [QxMD MEDLINE Link].

55. Lichtenstein D, Mezière G, Biderman P, Gepner A. The "lung point": an ultrasound sign specific to pneumothorax. Intensive Care Med. 2000 Oct. 26 (10):1434-40. [QxMD MEDLINE Link].

56. Contou D, Razazi K, Katsahian S, Maitre B, Mekontso-Dessap A, Brun-Buisson C, et al. Small-bore catheter versus chest tube drainage for pneumothorax. Am J Emerg Med. 2012 Oct. 30 (8):1407-13. [QxMD MEDLINE Link].

57. Bense L, Lewander R, Eklund G, Hedenstierna G, Wiman LG. Nonsmoking, non-alpha 1-antitrypsin deficiency-induced emphysema in nonsmokers with healed spontaneous pneumothorax, identified by computed tomography of the lungs. Chest. 1993 Feb. 103 (2):433-8. [QxMD MEDLINE Link].

58. Moore FO, Goslar PW, Coimbra R, Velmahos G, Brown CV, Coopwood TB Jr, et al. Blunt traumatic occult pneumothorax: is observation safe?--results of a prospective, AAST multicenter study. J Trauma. 2011 May. 70 (5):1019-23; discussion 1023-5. [QxMD MEDLINE Link].

59. Delius RE, Obeid FN, Horst HM, Sorensen VJ, Fath JJ, Bivins BA. Catheter aspiration for simple pneumothorax. Experience with 114 patients. Arch Surg. 1989 Jul. 124 (7):833-6. [QxMD MEDLINE Link].

60. Noppen M, Baumann MH. Pathogenesis and treatment of primary spontaneous pneumothorax: an overview. Respiration. 2003 Jul-Aug. 70 (4):431-8. [QxMD MEDLINE Link].

61. Zehtabchi S, Rios CL. Management of emergency department patients with primary spontaneous pneumothorax: needle aspiration or tube thoracostomy?. Ann Emerg Med. 2008 Jan. 51 (1):91-100, 100.e1. [QxMD MEDLINE Link].

62. Marquette CH, Marx A, Leroy S, Vaniet F, Ramon P, Caussade S, et al. Simplified stepwise management of primary spontaneous pneumothorax: a pilot study. Eur Respir J. 2006 Mar. 27 (3):470-6. [QxMD MEDLINE Link].

63. Ferrie EP, Collum N, McGovern S. The right place in the right space? Awareness of site for needle thoracocentesis. Emerg Med J. 2005 Nov. 22 (11):788-9. [QxMD MEDLINE Link]. [Full Text].

64. Wax DB, Leibowitz AB. Radiologic assessment of potential sites for needle decompression of a tension pneumothorax. Anesth Analg. 2007 Nov. 105 (5):1385-8, table of contents. [QxMD MEDLINE Link]. [Full Text].

65. Harcke HT, Pearse LA, Levy AD, Getz JM, Robinson SR. Chest wall thickness in military personnel: implications for needle thoracentesis in tension pneumothorax. Mil Med. 2007 Dec. 172 (12):1260-3. [QxMD MEDLINE Link].

66. Sanchez LD, Straszewski S, Saghir A, Khan A, Horn E, Fischer C, et al. Anterior versus lateral needle decompression of tension pneumothorax: comparison by computed tomography chest wall measurement. Acad Emerg Med. 2011 Oct. 18 (10):1022-6. [QxMD MEDLINE Link].

67. Givens ML, Ayotte K, Manifold C. Needle thoracostomy: implications of computed tomography chest wall thickness. Acad Emerg Med. 2004 Feb. 11 (2):211-3. [QxMD MEDLINE Link].

68. Zengerink I, Brink PR, Laupland KB, Raber EL, Zygun D, Kortbeek JB. Needle thoracostomy in the treatment of a tension pneumothorax in trauma patients: what size needle?. J Trauma. 2008 Jan. 64 (1):111-4. [QxMD MEDLINE Link].

69. Almoosa KF, Ryu JH, Mendez J, Huggins JT, Young LR, Sullivan EJ, et al. Management of pneumothorax in lymphangioleiomyomatosis: effects on recurrence and lung transplantation complications. Chest. 2006 May. 129 (5):1274-81. [QxMD MEDLINE Link].

70. Sedrakyan A, van der Meulen J, Lewsey J, Treasure T. Video assisted thoracic surgery for treatment of pneumothorax and lung resections: systematic review of randomised clinical trials. BMJ. 2004 Oct 30. 329 (7473):1008. [QxMD MEDLINE Link].

71. Schramel FM, Postmus PE, Vanderschueren RG. Current aspects of spontaneous pneumothorax. Eur Respir J. 1997 Jun. 10 (6):1372-9. [QxMD MEDLINE Link].

72. Chen JS, Hsu HH, Huang PM, Kuo SW, Lin MW, Chang CC, et al. Thoracoscopic pleurodesis for primary spontaneous pneumothorax with high recurrence risk: a prospective randomized trial. Ann Surg. 2012 Mar. 255 (3):440-5. [QxMD MEDLINE Link].

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75. O'Rourke JP, Yee ES. Civilian spontaneous pneumothorax. Treatment options and long-term results. Chest. 1989 Dec. 96 (6):1302-6. [QxMD MEDLINE Link].

76. Devanand A, Koh MS, Ong TH, Low SY, Phua GC, Tan KL, et al. Simple aspiration versus chest-tube insertion in the management of primary spontaneous pneumothorax: a systematic review. Respir Med. 2004 Jul. 98 (7):579-90. [QxMD MEDLINE Link].

77. Loddenkemper R, Schönfeld N. Medical thoracoscopy. Curr Opin Pulm Med. 1998 Jul. 4 (4):235-8. [QxMD MEDLINE Link].

78. Baumann MH, Strange C. Treatment of spontaneous pneumothorax: a more aggressive approach?. Chest. 1997 Sep. 112 (3):789-804. [QxMD MEDLINE Link].

79. van den Brande P, Staelens I. Chemical pleurodesis in primary spontaneous pneumothorax. Thorac Cardiovasc Surg. 1989 Jun. 37 (3):180-2. [QxMD MEDLINE Link].

Brian J Daley, MD, MBA, FACS, FCCP, CNSC Professor and Program Director, Department of Surgery, Chief, Division of Trauma and Critical Care, University of Tennessee Health Science Center College of Medicine

Brian J Daley, MD, MBA, FACS, FCCP, CNSC is a member of the following medical societies: American Association for the Surgery of Trauma, Eastern Association for the Surgery of Trauma, Southern Surgical Association, American College of Chest Physicians, American College of Surgeons, American Medical Association, Association for Academic Surgery, Association for Surgical Education, Shock Society, Society of Critical Care Medicine, Southeastern Surgical Congress, Tennessee Medical Association

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Shabir Bhimji, MD, PhD Cardiothoracic and Vascular Surgeon, Saudi Arabia and Middle East Hospitals

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Rebecca Bascom, MD, MPH Professor of Medicine, Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Pennsylvania State College of Medicine, Milton S Hershey Medical Center; Graduate Faculty Member, Pennsylvania State University College of Medicine and The Huck Institutes of the Life Sciences

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Michael G Benninghoff, DO, MS Attending Physician in Pulmonary and Critical Care Medicine, Christiana Medical Center

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Erik D Barton, MD, MS Associate Director, Assistant Professor, Department of Surgery, Division of Emergency Medicine, University of Utah Health Sciences Center

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H Scott Bjerke, MD, FACS Clinical Associate Professor, Department of Surgery, University of Missouri-Kansas City School of Medicine; Medical Director of Trauma Services, Research Medical Center; Clinical Professor, Department of Surgery, Kansas City University of Medicine and Biosciences

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Andrew K Chang, MD Associate Professor, Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Medical Center

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Daniel S Schwartz, MD, FACS Assistant Clinical Professor of Cardiothoracic Surgery, Mount Sinai School of Medicine; Chief of Thoracic Surgery, Huntington Hospital

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Robert L Sheridan, MD Assistant Chief of Staff, Chief of Burn Surgery, Shriners Burns Hospital; Associate Professor of Surgery, Department of Surgery, Division of Trauma and Burns, Massachusetts General Hospital and Harvard Medical School

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