Pneumothorax question

I know that some pneumos resolve on their own, regardless of whether they're traumatic or spontaneous, so I think it'd make sense that if a small one doesn't resolve on its own, you'd get a worsening of s/sx at the very least r/t a prolonged period of v O2.

I was just wondering- can you start with a small tension pneumothorax from a trauma that slowly increases in size? So maybe starts with a little rib type pain or minor chest pain and a few days later increases to a full pneumo that causes more severe symptoms like SOB and dizziness? Or would you start having more severe symptoms when it initially occurs? My knowledge base on pneumos is a little fuzzy, so thanks in advance.

Anything is possible, regardless if spontaneous or traumatic. No two people are the same and their compensatory skills will vary.

thanks guys

Sure, small pneumos can build up air in the pleural space over time, like days, and become symptomatic and apparent on xray. . This is why they can go undetected after say a subclavian line, where the lung is nicked. its a "a slow leak":

We are often discharging stable pneumothorax patients and asking them to have follow up chest X-rays (either in ED or outpatient) to check their progress. Also asked to return if symptoms worsen. Seems to save an inpatient bed plus no need for a drain which is a much nicer option for many people.

Do you mean a tension pneumothorax or a simple pneumothorax. A simple pneumothorax may not even be visible on a chest x-ray. If whatever caused the leak is still active then it can expand and grow with time.

A tension pneumothorax, not so much. For it to identifiable as a tension pneumothorax, you already have shift and it should be noticeable. Now a simple pneumothorax can progress to a tension.

Medscape: Medscape Access

[COLOR=#0066cc]Trauma.org | Tension Pneumothorax

https://www.youtube.com/watch?v=i-sZzZ4TMnY

[/COLOR]

As a medic who was deployed in combat, I can confirm that small tension pneumo, can possible progressively get worst. I had a buddy who suffered trauma and within the 4 and half hours or so it took for the bird to come and evac him. It had gotten worst. It depends on the leak of air in the pleural space, patient, MOI among many other things.

Hope that helps.