Pneumothorax

.

A 17-year-old boy presents with sudden onset of right pleuritic chest pain. His HR is 70 bpm and his oyxgen saturation is 98% on room air. He is comfortable, speaking in full sentences, and has decreased breath sounds on the right. His CXR is shown. [size=20px]While observed in the ER, the patient’s condition remains the same 4 hours later. What is the most appropriate management? A Repeat CXR B Obtain chest CT scan C Rigid bronchoscopy D Place pigtail chest tube and place to suction E Insert pigtail chest tube and place to water seal[/size]

see in next post

.

this video shows thoracoscopic, stapling resection of the apex of the lung in a 15 year old boy with spontaneous pneumothorax and pleural wall electro-scarification. see high quality video in next post

.

A three-month old male undergoes uncomplicated closure of a ventricular septal defect. On postoperative day three he develops a right pneumothorax [center][/center] tube thoracostomy is placed and another radiogrpah is obtained. [center][/center] [size=20px]Despite complete lung re-expansion, the infant has decreasing oxygen saturation and increased work of breathing. Your treatment plan for this infant with hypoxemia and a pneumothorax is A placement of left thoracostomy tube. B placement of second right thoracostomy tube. C cannulation for extracorporeal life support. D intubate if needed and provide appropriate supportive criti…