[Needle exsufflation could be the first line treatment of complete primary spontaneous pneumothorax at emergency...

Primary spontaneous pneumothorax (PSP) is associated with a low attributable morbidity-mortality because of absence of acute respiratory consequences in young and health subjects with normal baseline respiratory functions. In opposite, intercostal tube drainages, first-line surgical drainage or chemical pleurodesis are associated around 5% of complications or adverse effects. Guidelines were controversial, primary exsufflation becomes recommended, from now on. We report a case of a complete PSP coursed from four days in a current smoker patient. Needle exsufflation was first and once performed with mural suction associated with high-oxygen treatment allowed denitrogenation. Pneumothorax was resolved. Re-expansion oedema and subcutaneous emphysema occurred consecutively aspiration, immediately. Simple and favourable outcome occurred, secondarily. Because of simplicity, safety, immediate efficacy and its reproducibility, needle aspiration could be first purposed in complete PSP in absence of haemodynamic or gasometrical consequences even if several days delay is present.