Pneumothorax



 A 58 yr old male pt came with cheif complaints of 

Cough since 15 days 

Sob since 1 day 

Chest pain since 1 day 

HOPI 

Pt was apparently asymptomatic 15 days back after which he developed dry coughwhich was insidious in onset , progressive in nature , no postural /diurnal/seasonal variation 

Complaints of SOB Since 1 day , acute in onset , progressive in nature ,grade II -III , increased on exertion 

C/o chest pain since one day , acute in onset , increased during cough , non radiating , not associated with palpitations, sweating

No c/o fever , chest tightness,wheez, decreased urine output,orthopnea, pND,loss of weight, loss of appetite 

Past history 

H/o TB 1 yr back ( took ATT for 1 month )

N/k/c/o DM,HTN

chronic smoker for 40 yrs ( 1 pack beedies / day)

Chronic alcoholic for 40 yrs ( occational) 

Treatment history 

Took ATT for 1 month 1 yr back 

Personal history 

Occupation: farmer 

Appetite -normal 

Diet mixed 

BowelAnd bladder regular 

Sleep adequate 

Addictions :smoker since 40 yrs 1 pack / day

                    Alcohol occationally since 40 yrs 

Family history 

Not relevant 

General examination

Pt is consious , coherent , cooperative ,moderately built

No pallor, icterus, cyanosis, clubbing,lymphadenopathy, edema of feet 

Vitals :

Afebrile 

Bp: 120/70

PR:78

RR :26

GRBS: 95

Spo2 :95on RA

 

Respiratory examination



Cvs: s1 s2 heard 

Cns :NAD

Perabdomen: soft nontender 


PROVISIONAL DIAGNOSIS : left sided hydropneumothorax with collapse ?secondary to TB ,with old pulmonary kochs 

On 07/09/2021 

Chest x ray : before ICD 



  After ICD 




  Cbp:



Lft



Rft





Pt , aptt:



Bt and CT :



Serology : negative 

Ecg 


On 08/09/2021 

Chest x ray 



Treatment

On 07/09/2021

Inj VOVERON 75 mg/im/bd

InjTRAMADOL 50mg in 100 ml NS 

Inj METROGYL 500mg /TID 

Inj PAN 40mg OD 

TAB PCM 650mg TID 





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