Pneumothorax complicating pulmonary emphysema
R. B. George, S. J. Herbert, J. M. Shames, D. B. Ellithorpe, H. Weill and M. M. Ziskind
Clinical and roentgenographic findings were compared in patients 40 years
of age and over and in those under 40 who were treated for acute unilateral
pneumothorax. Dyspnea and anxiety were pominent in the older individuals,
although pneumothoraces were usually small. Because physical findings were
often unreliable, roentgenograms were required. In the presence of
pulmonary emphysema, loss of retractility prevented total collapse of the
underlying lung. Increased intrapleural pressure caused over-expansion of
the chest wall and the depression of the diaphragm without much mediastinal
shifting. Partial collapse of emphysematous lobes demonstrated bullae that
were not previously obvious. Respiratory failure developed in five patients
over 40 years of age, but four of them recovered after relief of the
pneumothorax. Mortality for the group was low and related to associated
pulmonary diseases.
