So why don't thoracentesis cause pneumothorax?

[HelpPleaseMD]

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Sorry if this is a basic question my anatomy sucks.

 

[Siggy]

Sorry if this is a basic question my anatomy sucks.

Are we talking about a small spontaneous pneumo? For that, why introduce a hole into the body when you don't have to?

 

[HelpPleaseMD]

I am referring to the process where the doctor decides to sample pleural effusion to check if its exudative, transudative, or full of chyme

 

[usmlesuccess]

I was actually thinking the same thing the other day, but I thought that I must be misunderstanding something. Conceptually, I think it might work like a tension pneumothorax, except without the negative consequences. The needle must be very thin, such that once the needle is taken out there is a seal that is formed, except unlike a tension pneumothorax, the flap where the needle was inserted is sealed both ways.

 

[HelpPleaseMD]

I was actually thinking the same thing the other day, but I thought that I must be misunderstanding something. Conceptually, I think it might work like a tension pneumothorax, except without the negative consequences. The needle must be very thin, such that once the needle is taken out there is a seal that is formed, except unlike a tension pneumothorax, the flap where the needle was inserted is sealed both ways.

that is what I assumed as well...but when I youtubed the procedure the needle seemed huge. You are probably right though

 

[defcon8]

You usually use a 3-way stopclock when doing the procedure. so when you are done draining/emptying the bag then you turn to stopclock to form a seal so no air can enter the pleural space. a pneumothorax is not an uncommon complication though, especially if the procedure isnt done with ideal equipment, so you usually get a post-thoracocentesis xray. on another note.. when you do needle thoracocentesis acutely to relieve a tension ptx, what you are in fact doing is converting the tension pneumothorax into an open pneumothorax which isnt as immediately life threatening. that is why you still need to put in a thoracostomy tube to clear it.

 

[HelpPleaseMD]

Thanks! I saw that in the video and completely glossed over it ... sigh