KUMJ | VOL. 18 | NO. 3 | ISSUE 71 | JULY-SEPT. 2020
Spontaneous Pneumothorax: Follow up Treatment Outcome in a Tertiary Care Center of Eastern Nepal
Ghimire RH, Ghimire A, Bista B, Yadav S, Shreewastav RK
Abstract: Background
Spontaneous pneumothorax is not an uncommon medical emergency in pulmonary
practice. Related data are not available in our setting. In emergency departments,
clinical presentation is often confused with other cardiopulmonary problems. Follow
up outcome is important for better patient care.
Objective
To study clinical profile and outcome after non surgical intervention in a tertiary care
center.
Method
This was a prospective observational study carried out in Nobel Medical College,
Biratnagar over last 3 years. We enrolled consecutive spontaneous pneumothorax
patients over 15 years of age. Each data related to individual patients were collected
in predefined proforma. To study follow up outcome of management, we used OPD
attendance or if not possible took, at least two telephone numbers from the patients.
All patients were followed for recurrences. Data was statistically analyzed using SPSS
software.
Result
Over the last 3 years, we enrolled 65 spontaneous pneumothorax patients. Secondary
spontaneous pneumothorax was more common (92.3%). Commonest presentations
were acute pleuritic chest pain (92.3%), dyspnea (84.62%) and cough (92.3%). COPD
(46.14%), PTB sequelae (15.38%), bronchiectasis (23.07%) and bullous lung disease
(23.07%) were common risk factors. Tube thoracostomy (95.38%) with pleurodesis
with iodopovidone (84.61%) led to lung expansion in 92.3% cases. During follow up,
only 4.61% had recurrences of pneumothorax. There was one mortality.
Conclusion
Spontaneous pneumothorax is a common pulmonary emergency. Meticulous and
careful assessment of the patients may help reach the diagnosis even in primary care
setting. Tube thoracostomy followed by pleurodesis with iodo-povidone suffices in
most circumstances leading lower future recurrences.
Keyword : Nepal, Spontaneous pneumothorax, Treatment outcome
