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Secondary spontaneous pneumothorax — SCE Respiratory MCQ

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HardPleural DiseaseSecondary spontaneous pneumothoraxSCE Respiratory

A 68-year-old man with severe emphysema develops pleuritic pain and dyspnoea. Chest radiograph shows a 3 cm right secondary spontaneous pneumothorax. He is breathless at rest but haemodynamically stable. What is the most appropriate management?

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Correct answer: B — Insert a small-bore chest drain

A symptomatic secondary spontaneous pneumothorax in severe COPD generally requires active intervention, often small-bore chest drain drainage depending on size and symptoms. Conservative management is more suited to minimally symptomatic selected cases. Pleurodesis may be considered for recurrence prevention but not before initial re-expansion in this presentation.

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