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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 sudden pleuritic chest pain while at rest. He is comfortable, SpO2 is 98% on air and chest radiograph shows a small primary spontaneous pneumothorax with a 1.5 cm rim at the hilum. There is no underlying lung disease and he lives near the hospital. Pain is controlled with oral analgesia. What is the most appropriate management?

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

Current BTS pleural guidance supports conservative management for selected minimally symptomatic primary spontaneous pneumothorax. Chest drain insertion would be disproportionate in a stable patient with a small pneumothorax. Symptom burden and physiological stability matter more than size alone in modern pneumothorax decisions.

Reference: https://www.brit-thoracic.org.uk/quality-improvement/guidelines/