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Medicine Pneumothorax 5ded7157

50 year old male known case of emphysema presents to OPD with complaint of shoness of breath for 2 weeks. Chest X Ray revealed 3 cm pneumothorax on the right side. What shall be the management approach for the patient ?

A
Repeated aspirations as chest drain inseion is dangerous if bullae are present
B
High flow oxygen and carefully monitor the patient
C
Inseion of Seldinger intercostal chest drain to cause resolution of pneumothorax
D
Inse a large bore chest drain as there may be a significant Air leak
High-Yield Explanation
This patient is having secondary Pneumothorax due to presence of underlying lung disease. Cut off used for large vs small pneumothorax is 3 cm distance from Apex. So this is a large symptomatic Pneumothorax and is treated with Seldinger chest drain. Choice A is used for small pneumothorax and can damage other bulla too Choice B is ruled out as we need to intervene actively in this case Choice D, Wide bore Chest drain is used for drainage of empyema, Hemothorax and Malignant pleural effusions.

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