Management of Pneumothorax

Dr Swapnil Pawar March 7, 2021 51

Management of Pneumothorax
Dr Swapnil Pawar

Written by – Dr Andrew Lam

FAST scan

View	Cavity Assessed	Findings
Subxiphoid	Pericardial	Assessing for anechoic (dark) fluid between the visceral and parietal pericardium suggestive of pericardial effusion.
Anterior Pleural	Pleural	Assessing for pleural effusion/haemothorax. Absence of lung sliding on respiration is also suggestive of pneumothorax.
Right Upper Quadrant	Peritoneal	Assesses Morrison’s Pouch (Hepatorenal Recess) for dependent anechoic fluid suggestive of intra-abdominal bleeding
Left Upper Quadrant	Peritoneal	Assesses Splenorenal Recess for dependent anechoic fluid suggestive of intra-abdominal bleeding
Pelvic	Pelvic	Assesses Pouch of Douglas (Rectouterine Pouch) or rectovesical pouch for anechoic fluid suggestive of pelvic bleeding

Radiological Signs of Pneumothorax

Visible visceral pleural edge with the absence of lung markings peripheral to this line
Peripheral space is lucent compared to the rest of the hemithorax
In cases of tension pneumothorax, you may see a mediastinal shift and tracheal deviation away from the lesion
Subcutaneous emphysema may be present
It May be associated with atelectasis

Triangle of Safety

Demarcates the anatomical region of the axilla which demarcates a guide for safe insertion of an intercostal catheter.

Borders:

Anteriorally: Lateral border of Pec Major

Posteriorally: Lateral border of Latissimus Dorsi

Inferiorally: 5th Intercostal Space

References:

Bickle, I., Gorrochategui, M. (2021). Pneumothorax. Radiopaedia. Retrieved February 23, 2021 from https://radiopaedia.org/articles/pneumothorax

Botz, B., Bickle, I. (2021). Focused Assessment with Sonography for Trauma (FAST) Scan. Radiopaedia. Retrieved February 23, 2021 from https://radiopaedia.org/articles/focussed-assessment-with-sonography-for-trauma-fast-scan

Hacking, C. (2021). Triangle of Safety. Radiopaedia. Retrieved February 23, 2021 from https://radiopaedia.org/articles/triangle-of-safety

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