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Primary spontaneous pneumothorax — RCPSC EM MCQ

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HardRespiratory emergenciesPrimary spontaneous pneumothoraxRCPSC EM

A 20-year-old tall man has sudden pleuritic chest pain while at rest. He is comfortable, oxygen saturation is 98% and chest radiograph shows a 2 cm apical pneumothorax. He has no underlying lung disease and no tension physiology. What is the most appropriate investigation?

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Correct answer: C — Repeat chest radiograph after a period of ED observation

Stable primary spontaneous pneumothorax can often be managed conservatively with observation and repeat imaging, depending on size, symptoms and local practice. Intervention is reserved for larger, symptomatic or unstable cases.

Reference: Canadian Thoracic Society pleural disease principles; Rosen's Emergency Medicine