Pneumothorax - secondary
Description
- Pneumothorax occurring in a lung with pre-existing disease
- The distinction from primary matters because the patient has no respiratory reserve - the same volume of air causes far more compromise, resolves more slowly, and recurs more often
Primary vs secondary
| Primary (PSP) | Secondary (SSP) | |
|---|---|---|
| Lung | Normal | Diseased |
| Typical patient | Tall thin young male smoker | Older, COPD, smoker |
| Symptoms | Often mild | Marked dyspnoea out of proportion to size |
| Mortality | ~0 | ~10% |
| Air leak resolution | Fast | Slow - prolonged air leak common |
| Recurrence | ~30% | ~40-50% |
| Management | Conservative/ambulatory often appropriate | Almost always admit |
- >50 years with significant smoking history is treated as secondary even if no lung disease is known
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