Management of spontaneous pneumothorax: about 138 cases

• Published in: The Pan African medical journal 2017, Vol.26, p.152-152
• Main Authors: Habibi, Bouchra, Achachi, Leila, Hayoun, Sohaib, Raoufi, Mohammed, Herrak, Laila, Ftouh, Mustapha El
• Format: Article
• Language: fre
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Chest Pain - epidemiology; Chest Pain - etiology; Drainage - methods; Dyspnea - epidemiology; Dyspnea - etiology; Female; Humans; Male; Middle Aged; Pneumothorax - diagnosis; Pneumothorax - etiology; Pneumothorax - therapy; Recurrence; Retrospective Studies; Young Adult
• ISSN: 1937-8688
• DOI: 10.11604/pamj.2017.26.152.11437

Pneumothorax is a collection of air in the pleural cavity. We conducted a retrospective study of patients with spontaneous pneumothorax in the Department of Pneumology at the Ibn Sina Hospital in Rabat (2009-2011) with the aim to determine the epidemiological, clinical, radiological, therapeutic and evolutionary manifestation of spontaneous pneumothorax. The study involved 138 patients: 128 men and 10 women (17-83 years), with an average age of 44.5 +/- 17.4 years and sex ratio of 12/8. 81.2% of patients were smokers. Clinical symptomatology was chest pain (92%), dyspnea (60%). Chest radiograph showed total unilateral (110 cases); partial (10 cases); localized (6 cases); bilateral (4 cases); right (51.4%) or left (45.7%) PNO (pneumothorax). During our study period we found that 70% of patients had spontaneous primitive pneumothorax and 30% had PNO secondary to Chronic obstructive pulmonary disease (COPD) (44%) and pulmonary tuberculosis (TB) (39%). Initial management included patients hospitalization, chest drainage (95%), needle exsufflation (1%), rest and O (4%). It enables the lung to stick to the chest wall within 10 days in 63% of patients. Evolution was favorable in 89% of patients. Immediate complications included: subcutaneous emphysema (5 cases); infection (6 cases) and 3 deaths (cardiorespiratory arrest). Late complications included: recurrences in 11.6%; the first recurrence occurred in 13 cases (chest drainage in 11 cases and oxygen therapy in 2 cases) while the second recurrence occurred in 3 cases (surgery). This study shows the role of chest drainage and monitoring in the management of pneumothorax to avoid complications and especially to prevent recurrences, with a possible need to resort to surgery.