[Sonographic diagnosis of post-interventional pneumothorax and hydropneumothorax--prospective study of 100 patients]

In order to answer the question, if transthoracic sonography may replace chest radiographs in diagnosing post-interventional pneumothorax/hydropneumothorax, this prospective study was conducted. A total of 100 patients (38 females, 62 males; median age 63 years), biopsy and 37 had an ultrasound-guided tube thoracostomy, were enrolled in the study. Transthoracic sonography was performed three hours after the intervention, followed by postero-anterior chest radiograph. One (1%) of the 100 patients developed a pneumothorax after transbronchial biopsy. Eight of 37 patients suffered from hydropneumothorax due to tube thoracostomy detected by sonography. In one patient, hydropneumothorax was missed by posteroanterior chest radiography. Sensitivity, specificity and accuracy of transthoracic sonography were 100%. Transthoracic sonography is a safe bed-side-method, allowing an immediate exclusion/diagnosis of postinterventional pneumothorax/hydropneumothorax. The results suggest that chest radiography may only be required in patients with pneumothorax diagnosed by transthoracic sonography so as to assess its extension, if full sonographic assessment is not possible or if any discrepancy exists between TS-results and clinical presentation.