Primary spontaneous pneumothorax (PSP) is a common disease in medical practice that affects young healthy people with a significant recurrence rate. PSP is the presence of air in the pleural space not caused by injury or medical intervention. Some risk factors include male gender, age, and smoking. Classic clinical presentation starts with acute-onset chest pain and shortness of breath. Physical examination can be normal in small pneumothoraces, but in larger pneumothoraces, breath sounds and tactile fremitus are typically decreased or absent, and percussion is hyperresonant. Chest X-ray can help confirm the diagnosis. Evacuation of air from the pleural cavity and prevention of future recurrences are the primary goals of treatment and depend on the patient’s presentation. Initial deciding factors to direct the management are first-time or recurrent spontaneous pneumothorax and size of the pneumothorax. Treatment may include conventional chest tube drainage, video-assisted thoracoscopic surgery (VATS), or open surgery.
Part of the book: Pneumothorax