Primary spontaneous pneumothorax: diagnosis, complication, treatment

master's thesis

• Title (croatian): Primarni spontani pneumotoraks: dijagnoza, komplikacije, liječenje
• Author: Mirwais Daulatzai
• Mentor: Vesna Degoricija (mentor)
• Committee member: Vesna Degoricija (predsjednik povjerenstva)
• Committee member: Radovan Radonić (član povjerenstva)
• Committee member: Miroslav Samaržija (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2019-09-10, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Today, the etiology of primary spontaneous pneumothorax (PSP) in the most cases can be identified which has led to its better understanding and management. It is mainly caused by the rupture of a small subpleural emphysematous vesicle (designated a bleb) or of a subpleural paraseptal emphysematous lesion (designated a bulla). The most effective diagnostic procedure amongst numerous imaging modalities is the ultrasound using Daniel Lichtenstein's method. This imaging technique is the gold standard for clinicians to detect pneumothorax. Complications associated with PSP are low with first-time diagnosis and it includes prolong air leakage (7% to 14%) with conservative treatment. However, there are procedural and non-procedural complications and all of which can lead to recurrent form of pneumothorax. The treatment options depend on various factors including patients' current health status, age, type and size of the pneumothorax on CT scan, complications, severity of symptoms and indicators of acute illness. Treatment of PSP range from conservative to immediate needle decompression or insertion of a chest tube. Latest modalities of treatment of PSP include the use of video-assisted thoracoscopic surgery (VATS) and in some cases chemical pleurodesis.

Abstract (croatian)

Danas se etiologija primarnog spontanog pneumotoraksa (PSP) u većini slučajeva može otkriti što je dovelo do boljeg shvaćanja i zbrinjavanja ovog oblika pneumotoraksa. Najčešće je uzrokovan rupturom malog subpleuralnog emfizematoznog mjehurića (tzv. bleba) ili subpleuralne paraseptalne emfizematske lezije (tzv. bulla). Najučinkovitija dijagnostička pretraga među brojnim radiološkim modalitetima je ultrazvuk, korištenjem Daniel Lichtensteinove metode. Ova radiološka metoda predstavlja „zlatni standard“ i metodu izbora kojom liječnici mogu otkriti pneumotoraks. Komplikacije povezane s PSP-om su rijetke s prvom epizodom i uključuju produljeno curenje zraka (7 do 14%) s konzervativnim liječenjem. Međutim, postoje proceduralne i neproceduralne komplikacije koje sve mogu dovesti do recidivirajućeg pneumotoraksa. Metode liječenja ovise o mnogo čimbenika, uključujući trenutno pacijentovo zdravstveno stanje, dob, tip i veličinu pneumotoraksa na CT-u, ozbiljnost simptoma te pokazatelje akutne bolesti. Metode zbrinjavanja sežu od konzervativnog liječenja do hitne dekompresije iglom ili uvođenja torakalnog drena. Najnovije metode liječenja PSP-a uključuju uporabu video-asistirane torakoskopske kirurgije (VATS) i u nekim slučajevima kemijsku pleurodezu.

• Keywords: pneumothorax; pleural cavity; treatment; complications; CTS; CXR; chest tube drainage; video-assisted thoracoscopic surgery
• Keywords (croatian): pneumotoraks; pleuralni prostor; liječenje; komplikacije; CTS; RTG; torakalni dren; video-asistirana torakoskopska kirurgija
• Language: english
• URN:NBN: urn:nbn:hr:105:676152
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-07-20 07:48:36