Background: Thoracoscopy has used for lots of thoracic disorders. Pneumothorax may be ideally suited for thoracoscopic management. Objective: To study the value of thoracoscopy in the diagnosis and treatment of pneumothorax. Subjects and method: From September 2003 to October 2006, 30 patients with pneumothorax were treated by thoracoscopy at Department of Respiratory of Bach Mai Hospital. This was a longitudinal, retrospective and prospective study. Prospective study included 15 patients from September 2005 to October 2006. Retrospective study included 15 patients from September 2003 to August 2005. Results: In 30 patients, primary spontaneous pneumothorax accounted for 80%, secondary spontaneous pneumothorax 13.3%, catamenial pneumothorax 3.3% and iatrogenic pneumothorax 3.3%. Mean age of patients was 34\xb115 years (ranged from 17 to 77 years). 90% of cases were male. Bullea was found in 70% by thoracoscopy. Patients were in stage I 13.3%, stage II 20%, stage III 33.3%, and stage IV 33.3%. There were 3 procedures with ligation, 11 procedures with coagulator, 25 procedures with talc poudrage; mean dose of talc was 8.2\xb12.2 g. The success rates of procedures with talc poudrage were 80% and 100% after supplemental pleurodesis. Complications and side effects were subcutaneous emphysema 46.7%, empyema 3.3%, high fever 3.3% that we thought was nosocomial infections, bleeding in pleural cavity 3.3%, chest pain 96.7%, fever 63.3%, dyspnea 10%. After a mean follow up of 14.1\xb110.4 months, the recurrent rate was 3.3%. Conclusions: Medical thoracoscopy achieved a high success rate in the diagnosis and treatment of pneumothorax.
Pneumothorax/ diagnosis ; therapy ; Thoracoscopy

Humans ; Pneumothorax ; therapy ; Silicosis ; therapy

We report two patients, who have used Pneumostat to replace the conventional underwater seal drainage system for recurrent pneumothorax. Both patients had required repeated chest tube insertion for recurrent pneumothorax and needed a longer hospital stay. Both patients were able to be discharged with the Pneumostat device and were reviewed in outpatient clinic. Both patients had optimal clinical improvement and chest X-ray showed no residual pneumothorax.
*Ambulatory Care ; *Chest Tubes ; Drainage/*instrumentation ; Pneumothorax/*therapy

OBJECTIVETo observe the clinical effect of central venous catheter in the treatment of refractory pleural effusion and pneumothorax.

METHODSPatients with coal workers' pneumoconiosis-tuberculosis complicated by pleural effusion or pneumothorax were randomly divided into central venous catheter group (48 cases, treated by chest drainage using a peripherally inserted central catheter) and conventional puncture group (56 cases, treated by conventional pleural puncture). Chemotherapy (DOTS strategy) was fully supervised, and both groups used 3HRZE/6HR (H, isoniazid; R, rifampicin; Z, pyrazinamide; E, ethambutol).

RESULTSIn the central venous catheter group, catheterization in the thoracic cavity was performed once in all cases, without fall-off; the mean total volume of pumped effusion was 3932±4430 ml; the time to disappearance of pleural effusion and pneumatosis was 10±2 d; 40 (83.33%) of the 48 cases were cured. In the conventional puncture group, the volume of pumped effusion was 2753±315 ml; the time to disappearance of pleural effusion and pneumatosis was 18±6 d; pleural puncture was performed twice in 4 cases, 3-4 times in 38 cases, and over 5 times in 10 cases, with an average of 3.8 times; 26 (46.43%) of the 56 cases were cured. The cure rate was significantly higher in the central venous catheter group than in the conventional puncture group (χ(2) = 7.59, P < 0.01).

CONCLUSIONFor pleural effusion and pneumothorax, PICC can be used instead of closed thoracic drainage and pleural puncture, and it has good clinical effect, causes little pain, and is easy to operate.

Anthracosis ; Catheterization ; Central Venous Catheters ; Drainage ; Humans ; Pleural Effusion ; complications ; therapy ; Pneumothorax ; complications ; therapy

OBJECTIVETo study the clinical characteristics and treatment method of pneumonoconiosis with spontaneous pneumothorax.

METHODSThe clinical data of 55 cases with spontaneous pneumothorax were analyzed.

RESULTSAmong these 55 cases, there were 19 cases with left side pneumothorax, 25 cases with right side pneumothorax and 11 cases with bilateral pneumothorax. The lungs of 17 cases were compressed to less than 20%, the lungs of 29 cases were compressed to 20% ∼ 50% and the lungs of 9 cases were compressed to more than 50%, 17 cases were treated conservatively, 7 cases were treated by thoracentesis, and 32 cases were treated by closed thoracic drainage, including 10 cases intrapleural injected with thrombin and PAMBA. After the treatment, 41 cases were cured, 10 cases were improved, 3 cases were transferred to other hospital for plugging or pleurodesis and 1 case died of the respiratory failure.

CONCLUSIONThe clinical symptoms of cases with pneumonoconiosis and spontaneous pneumothorax are atypical. These cases easily recur. After treatment, the healing of these cases is better.

Adult ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; diagnosis ; therapy ; Pneumothorax ; complications ; diagnosis ; therapy

For the German speaking countries, Tscherne's definition of "polytrauma" which represents an injury of at least two body regions with one or a combination being life-threatening is still valid. The timely and adequate management including quick referral of the trauma patient into a designated trauma center may limit secondary injury and may thus improve outcomes already during the prehospital phase of care. The professional treatment of multiple injured trauma patients begins at the scene in the context of a well structured prehospital emergency medical system. The "Primary Survey" is performed by the emergency physician at the scene according to the Prehospital Trauma Life Support (PHTLS)-concept. The overall aim is to rapidly assess and treat life-threatening conditions even in the absence of patient history and diagnosis ("treat-first-what-kills-first"). If no immediate treatment is necessary, a "Secondary Sur- vey" follows with careful and structured body examination and detailed assessment of the trauma mechanism. Massive and life-threatening states of hemorrhage should be addressed immediately even disregarding the ABCDE-scheme. Critical trauma patients should be referred without any delay ("work and go")toTR-DGU® certified trauma centers of the local trauma networks. Due to the difficult pre- hospital environment the number of quality studies in the field is low and, as consequence, the level of evidence for most recommendations is also low. Much information has been obtained from different care systems and the interchangeability of results is limited. The present article provides a synopsis of rec- ommendations for early prehospital care for the severely injured based upon the 2011 updated multi- disciplinary S3-Guideline "Polytrauma/Schwerstverletzten Behandlung", the most recently updated European Trauma guideline and the current PHTLS-algorithms including grades of recommendation whenever possible.
Airway Management ; Emergency Medical Services ; Fluid Therapy ; Fractures, Bone ; therapy ; Germany ; Hemostatics ; therapeutic use ; Humans ; Multiple Trauma ; therapy ; Pneumothorax ; therapy

Physical traumas are tragic and multifaceted injuries that suddenly threaten life. Although it is the third most common cause of death in all age groups, one out of four trauma patients die due to thoracic injury or its complications. Blunt injuries constitute the majority of chest trauma. This indicates the importance of chest trauma among all traumas. Blunt chest trauma is usually caused by motor vehicle accident, falling from height, blunt instrument injury and physical assault. As a result of chest trauma, many injuries may occur, such as pulmonary injuries, and these require urgent intervention. Chest wall and pulmonary injuries range from rib fractures to flail chest, pneumothorax to hemothorax and pulmonary contusion to tracheobronchial injuries. Following these injuries, patients may present with a simple dyspnea or even respiratory arrest. For such patient, it is important to understand the treatment logic and to take a multidisciplinary approach to treat the pulmonary and chest wall injuries. This is because only 10% of thoracic trauma patients require surgical operation and the remaining 90% can be treated with simple methods such as appropriate airway, oxygen support, maneuvers, volume support and tube thoracostomy. Adequate pain control in chest trauma is sometimes the most basic and best treatment. With definite diagnosis, the morbidity and mortality can be significantly reduced by simple treatment methods.
Flail Chest ; therapy ; Hemothorax ; therapy ; Humans ; Lung Injury ; therapy ; Pain Management ; Pneumothorax ; therapy ; Rib Fractures ; therapy ; Thoracic Injuries ; therapy ; Thoracic Wall ; injuries ; Wounds, Nonpenetrating ; therapy

Self-induced pneumoparotitis is a rare cause of swelling of the parotid gland. It has been reported to be a result of psychosomatic disorder, unintentional habit, and it is sometimes self-induced by patients to achieve secondary gain. We report a case of a 18-year-old man who had a self-induced pneumoparotitis complicated by recurrent parotitis, subcutaneous emphysema and pneumomediastinum. With repeated behavior of insufflation, parotid acini may rupture and air may extend into the retropharyngeal space, causing pneumomediastinum or pneumothorax. In self-induced cases, treatment should necessitate psychologic therapy for behavior modification.
Adolescent ; Behavior Therapy ; Humans ; Insufflation ; Mediastinal Emphysema ; Parotid Gland ; Parotitis ; Pneumothorax ; Psychophysiologic Disorders ; Rupture ; Subcutaneous Emphysema

Aged ; Anthracosis ; complications ; Catheterization ; Drainage ; methods ; Humans ; Male ; Middle Aged ; Pleural Effusion ; etiology ; therapy ; Pneumothorax ; etiology ; therapy ; Retrospective Studies

Equipment Design ; Humans ; Needles ; standards ; Paracentesis ; instrumentation ; methods ; Pleural Effusion ; therapy ; Pneumothorax ; therapy ; Punctures ; instrumentation ; methods ; Treatment Outcome