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Primary spontaneous pneumothorax — SCE Respiratory MCQ

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EasyPleural DiseasePrimary spontaneous pneumothoraxSCE Respiratory

A 23-year-old tall man presents with pleuritic pain and mild dyspnoea. CXR shows a moderate primary spontaneous pneumothorax; he is haemodynamically stable and can walk around the department comfortably. SpO2 is 97% on air. What is the most appropriate management?

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Correct answer: B — Conservative management with safety-netting and follow-up

Recent BTS guidance allows conservative management for selected minimally symptomatic stable primary spontaneous pneumothorax. Large-bore drainage and thoracotomy are excessive in this stable patient. Pleurodesis is generally reserved for recurrence, persistent air leak or high-risk circumstances rather than a mild first episode.

Reference: BTS Pleural Disease Guideline 2023