Pneumothorax: a review of 146 adult cases admitted at a university teaching hospital in Pakistan.
OBJECTIVE
There is a lack of data on the etiology and outcome of pneumothorax among the Pakistani population. Our aim was to review the etiology, clinical course, management and outcome of patients presenting with pneumothorax.


METHODS
All adult cases with pneumothorax admitted to a University Teaching Hospital in Karachi, between January 1992 and June 1996, were reviewed and analyzed.


RESULTS
A total of 146 patients were reviewed. Their mean age was 46.3 years (SD +/- 17.8 years) with a male to female ratio of 3.7:1. Secondary pneumothorax was the commonest type seen (45%), followed by traumatic (21%), iatrogenic (18%) and primary (16%). Tuberculosis (47%) and COPD (45%) were most common lung diseases associated with secondary pneumothorax. Pneumothorax secondary to TB presented at an earlier age than that with COPD (49.6 vs. 60.1 years). Similarly, patients with primary pneumothorax were significantly younger than patients with secondary pneumothorax (42.3 vs. 51.7 years). Rib fracture was the most common cause of traumatic pneumothorax. Coronary artery bypass grafting, transthoracic fine needle aspiration and neck vein cannulations were the leading iatrogenic causes. The commonest symptoms of pneumothorax were dyspnea (68%) and chest pain (40%). Most cases (81%) were successfully managed by intercostal tube drainage.


CONCLUSIONS
In our study population, secondary pneumothorax was the commonest variety seen. TB was the commonest cause of secondary pneumothorax, closely followed by COPD. Nearly 40% of pneumothorax were either traumatic or iatrogenic. Intercostal tube drainage remains the treatment of choice for pneumothorax.
Hussain
S F
SF
Department of Medicine, Aga Khan University Hospital, Karachi.
Aziz
A
A
Fatima
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D011030:Pneumothorax / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications