Spontaneous Pneumothorax: Pathophysiology, Clinical Presentation and Diagnosis

Gilday, Cassandra; Odunayo, Adesola; Hespel, Adrien‐Maxence

doi:10.1016/j.tcam.2021.100563

Cited by 17 publications

(11 citation statements)

References 43 publications

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“…However, the reported detection sensitivities of CT for pulmonary air-filled lesions in dogs with spontaneous pneumothorax vary considerably, ranging from 42.3% to 75% ( 13 , 20 ). Consequently, the clinical efficacy of CT in detecting air-filled lesions in dogs with spontaneous pneumothorax has been deemed limited ( 12 ). In the current study, the initial CT examination without positive pressure ventilation (pre-PPV CT) yielded a detection sensitivity of 62.5% (5/8 dogs) for air-filled lesions, which aligns with previous findings ( 13 , 20 ).…”

Section: Discussionmentioning

confidence: 99%

Improved detection of air-filled lesions using computed tomography in dogs with recurrent spontaneous pneumothorax through reduction of pulmonary atelectasis via positive pressure ventilation

Toshima,

Fulkerson,

Kagawa

et al. 2024

Front. Vet. Sci.

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IntroductionSpontaneous pneumothorax in dogs is predominantly caused by the rupture of air-filled lesions, such as bullae or blebs. The efficacy of Computed Tomography (CT) in detecting these lesions has been deemed limited due to its reportedly low sensitivity. This retrospective, cross-sectional study investigates the utility of CT in eight dogs diagnosed with recurrent pneumothorax, all of which had surgical confirmation of the cause of the pneumothorax.Materials and methodsThoracic radiographs were obtained before and the day following the CT studies. Initially, a CT study was conducted without positive pressure ventilation (pre-PPV CT). Subsequent CT studies were performed post-evacuation of pneumothorax and with positive pressure ventilation of 15 cmH2O until lung atelectasis was resolved (post-PPV CT). The pre-PPV CT and post-PPV CT images were anonymized and reviewed by two board-certified radiologists. The presence and morphology of air-filled lesions were evaluated on all images. Surgical findings were recorded and compared to the CT findings.ResultsAir-filled lesions were detected in 5 out of 8 dogs in the pre-PPV CT studies and in all 8 dogs in the post-PPV CT studies. The CT findings of air-filled lesions were consistent with surgical findings. None of the dogs showed increased severity of pneumothorax in radiographs taken the day following the CT studies.DiscussionsThe study concludes that the resolution of lung atelectasis by evacuation of pneumothorax and positive pressure ventilation during CT studies is feasible and enhances the detection of air-filled lesions in dogs with recurrent spontaneous pneumothorax. This could potentially aid in improving surgical planning.

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Section: Discussionmentioning

confidence: 99%

Improved detection of air-filled lesions using computed tomography in dogs with recurrent spontaneous pneumothorax through reduction of pulmonary atelectasis via positive pressure ventilation

Toshima,

Fulkerson,

Kagawa

et al. 2024

Front. Vet. Sci.

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“…However, these respiratory diseases can be identified through simple physical examination: diminished breath sounds in pneumothorax, wheezing in asthma, respiratory infection symptoms, abnormal breath sounds in pneumonia, etc. [ 40 , 41 , 42 , 43 , 44 ]. While X-rays can assist in diagnosing these conditions, a thorough medical history and physical examination are sufficient for initial exclusion.…”

Section: Etiology Of Chest Pain In Children and Adolescentsmentioning

confidence: 99%

Pediatric Chest Pain: A Review of Diagnostic Tools in the Pediatric Emergency Department

Huang,

Liu

2024

Diagnostics

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Pediatric chest pain is a common chief complaint in the emergency department. Not surprisingly, children with chest pain are usually brought to the emergency department by their parents out of fear of heart disease. However, chest pain in the pediatric population is generally a benign disease. In this review, we have identified musculoskeletal pain as the most prevalent etiology of chest pain in the pediatric population, accounting for 38.7–86.3% of cases, followed by pulmonary (1.8–12.8%), gastrointestinal (0.3–9.3%), psychogenic (5.1–83.6%), and cardiac chest pain (0.3–8.0%). Various diagnostic procedures are commonly used in the emergency department for cardiac chest pain, including electrocardiogram (ECG), chest radiography, cardiac troponin examination, and echocardiography. However, these examinations demonstrate limited sensitivity in identifying cardiac etiologies, with sensitivities ranging from 0 to 17.8% for ECG and 11.0 to 17.2% for chest radiography. To avoid the overuse of these diagnostic tools, a well-designed standardized algorithm for pediatric chest pain could decrease unnecessary examination without missing severe diseases.

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“…P neumothorax represents the presence of air in the pleural space due to the loss of visceral or parietal pleural membrane integrity that allows air from the environment or respiratory tract to enter and accumulate in the pleural space [1,2]. Pneumothorax can be spontaneous (primary and secondary) or acquired (traumatic and iatrogenic) [3].…”

Section: Introductionmentioning

confidence: 99%

Spontaneous pneumothorax in a young male athlete: A case report with review of literature

Maglica¹,

Jurčević²,

Jurčević³

et al. 2023

Indian J Case Reports

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Spontaneous pneumothorax (SP) is a serious and life-threatening condition often caused by ruptured apical lung bulla in young male individuals. It is commonly associated with different syndromes but also occurs in healthy individuals. In this case report, we aim to discuss the etiology, clinical course, and surgical treatment of a 21-year-old male kickboxer with a right-sided pneumothorax that occurred during a sparring session. A chest tube with negative suction was inserted to resolve the pneumothorax. Because there was no visible resolution, video-assisted thoracoscopic surgery (VATS) was performed. During VATS, a large, apically placed, ruptured lung bulla, was revealed and removed. One month after surgery, the patient is in great clinical condition. There are no signs of a recurrence of SP.

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Spontaneous Pneumothorax: Pathophysiology, Clinical Presentation and Diagnosis

Cited by 17 publications

References 43 publications

Improved detection of air-filled lesions using computed tomography in dogs with recurrent spontaneous pneumothorax through reduction of pulmonary atelectasis via positive pressure ventilation

Improved detection of air-filled lesions using computed tomography in dogs with recurrent spontaneous pneumothorax through reduction of pulmonary atelectasis via positive pressure ventilation

Pediatric Chest Pain: A Review of Diagnostic Tools in the Pediatric Emergency Department

Spontaneous pneumothorax in a young male athlete: A case report with review of literature

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