Alternate therapy for traumatic pneumothorax in "pocket shooters".
Traumatic pneumothorax is a common complication of the IV drug abusers in Detroit who utilize the "pocket shot" (the central approach to the internal jugular vein). Fourteen patients who sustained a total of 16 pneumothoraces (two with bilateral collapse) and who underwent catheter aspiration of a simple pneumothorax (CASP) were studied prospectively. The sizes ranged from less than 10% to 100%. In addition, there was one tension pneumothorax and one pneumomediastinum. The 16 CASP procedures produced 13 successful lung expansions (82%). The remaining three were treated with tube thoracostomy and admission. Twelve of the 13 patients in whom the procedure was successful returned for followup, and all of these had 100% continued full expansion. CASP appears to be a safe, efficacious, and cost-effective treatment for the drug abuser with simple traumatic pneumothorax. With the current pressures of cost containment, this less-invasive approach with outpatient management should be studied as initial potential treatment for any simple pneumothorax.
D000328:Adult; D002404:Catheterization / Q000379:methods*; D004630:Emergencies; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007601:Jugular Veins; D008297:Male; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D011446:Prospective Studies; D011859:Radiography; D019966:Substance-Related Disorders