Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- dor torácica
- dispneia
- hemitórax ipsilateral hiperexpandido
- hemitórax ipsilateral com hiper-ressonância
- murmúrios vesiculares ipsilaterais ausentes ou diminuídos
- dispneia extrema
- traqueia desviada para o lado contralateral
Risk factors
- tabagismo
- história familiar de pneumotórax
- estrutura corporal alta e magra
- idade <40 anos
- procedimento médico invasivo recente
- trauma torácico
- asma aguda grave
- doença pulmonar obstrutiva crônica (DPOC)
- tuberculose
- infecção por Pneumocystis jirovecii relacionada à síndrome de imunodeficiência adquirida (AIDS)
- fibrose cística
- linfangioleiomiomatose
- Síndrome de Marfan
- homocistinúria
- câncer de pulmão primário e câncer metastático nos pulmões
- síndrome de Birt-Hogg-Dube
- histiocitose pulmonar das células de Langerhans
- doença de Erdheim-Chester
Diagnostic investigations
1st investigations to order
- radiografia torácica
- ultrassonografia do tórax
Investigations to consider
- tomografia computadorizada (TC) do tórax
- broncoscopia
Treatment algorithm
pneumotórax hipertensivo
pneumotórax espontâneo primário E paciente ≤ 50 anos de idade
pneumotórax espontâneo primário OU paciente > 50 anos de idade
pneumotórax traumático
pneumotórax ex-vacuo
pneumotórax catamenial
Contributors
Authors
Christopher Kapp, MD
Assistant Professor of Medicine, Interventional Pulmonologist
Division of Pulmonary and Critical Care, Section of Interventional Pulmonary
Northwestern Memorial Hospital
Chicago
IL
Disclosures
CK declares that he has no competing interests.
Acknowledgements
Dr Christopher Kapp would like to gratefully acknowledge Dr Lonny Yarmus, Dr Jason Akulian, Dr Ryland P. Byrd Jr, Dr Thomas M. Roy, and Dr Anita Alwani, previous contributors to this topic.
Disclosures
LY, JA, RPB, TMR, and AA declare that they have no competing interests.
Peer reviewers
Marc Noppen, MD
Professor and Chief Executive Officer of Respiratory Division
Interventional Endoscopy Clinic
University Hospital Brussels
Brussels
Belgium
Disclosures
MN declares that he has no competing interests.
Steve A. Sahn, MD
Professor of Medicine
Division of Pulmonary Critical Care, Allergy and Sleep Medicine
Medical University of South Carolina
Charleston
SC
Disclosures
SAS declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
British Thoracic Society. Guidelines: pleural disease. Jul 2023 [internet publication].Full text
British Thoracic Society. Clinical statements: pleural procedures. Jul 2023 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Exacerbação aguda da asma
- Exacerbação aguda da doença pulmonar obstrutiva crônica (DPOC)
- Embolia pulmonar
More DifferentialsGuidelines
- BTS Guidelines on Pleural Disease
- ACR appropriateness criteria: intensive care unit patients
More GuidelinesPatient information
Pneumotórax
Inserção de dreno torácico
More Patient informationVideos
Descompressão por agulha de um pneumotórax hipertensivo – Vídeo de demonstração
Inserção de dreno intercostal, técnica de Seldinger: vídeo de demonstração
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