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Related Concept Videos

Pneumothorax-II01:27

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Pneumothorax II: Pathophysiology01:08

Pneumothorax II: Pathophysiology

Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance between...
Pneumothorax-I01:26

Pneumothorax-I

A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Flail Chest-II01:26

Flail Chest-II

Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Pulmonary Embolism III: Nursing Management01:27

Pulmonary Embolism III: Nursing Management

A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...

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Related Experiment Video

Updated: Jun 23, 2026

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
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Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device

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Recurrent Pneumothorax Following Multilevel Posterior Spinal Fixation in a Patient With Pre-Existing Pulmonary

Parisa Mirzaei1, Zahra Baghani2, Mohammad Javad Mousavi3,4

  • 1Rajaee Trauma Hospital Shiraz University of Medical Sciences Shiraz Iran.

Respirology Case Reports
|June 22, 2026
PubMed
Summary

Recurrent pneumothorax after spinal fixation can be fatal. Retaining chest tubes until after posterior spinal surgery is recommended, even if lungs appear expanded on X-ray, to prevent life-threatening complications.

Keywords:
alveolar‐pleural fistulachest tube managementmaritime accidentpolytraumapositive pressure ventilationposterior spinal fixationpulmonary contusionrecurrent pneumothorax

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Area of Science:

  • Trauma Surgery
  • Thoracic Surgery
  • Orthopedic Surgery

Background:

  • Recurrent pneumothorax is a rare but severe complication after posterior spinal fixation.
  • Polytrauma patients with pulmonary contusions are at higher risk.
  • Standard criteria for chest tube removal may be insufficient in these cases.

Purpose of the Study:

  • To highlight the risks of premature chest tube removal before spinal surgery.
  • To emphasize the importance of continued chest drainage in patients with pulmonary contusions.
  • To recommend a modified management strategy for chest tubes in spinal surgery patients.

Main Methods:

  • Case report of a 19-year-old male polytrauma patient with T12 fracture and pulmonary contusion.
  • Management of initial pneumothorax with chest tube, followed by posterior spinal fixation.
  • Observation of recurrent pneumothorax postoperatively despite initial radiographic resolution.

Main Results:

  • The patient developed massive recurrent pneumothorax immediately after posterior spinal fixation.
  • Urgent re-intervention was required to manage the recurrent pneumothorax.
  • The patient ultimately recovered fully after tertiary care.

Conclusions:

  • Radiographic lung re-expansion alone is not a sufficient criterion for chest tube removal before spinal surgery.
  • Prone positioning and ventilation can exacerbate occult air leaks in contused lungs.
  • Chest tubes should be retained until after posterior spinal fixation to prevent catastrophic recurrence.