“The lung is up ...”
“The lung is up ...”
A 54 year old man presented to a district hospital with left sided pain and shortness of breath. He had been a heavy smoker till 5 years before. Chest Xray showed a left sided pneumothorax. A well placed apical drain resulted in re-expansion of the lung. The drain was removed 5 days later and the patient discharged.
Re-admission
He returned 10 days after feeling unwell and more breathless.
He was referred to the regional thoracic unit as a loculated empyema.
CT scan showed that despite the chest Xray appearances there was an anterior pneumothorax. It also showed consolidation of the lower lobe and a slightly loculated effusion at the left base.
There was no growth after 48 hours culture of the pleural fluid.
As this is a secondary pneumothorax due to chronic airways disease prophylaxis is recommended. Talc pleurodesis (slurry via chest drain) was perfomed.