Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Pneumonia por Pneumocystis/diagnóstico , Idoso , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/microbiologia , Diabetes Mellitus Tipo 2/patologia , Diagnóstico Diferencial , Humanos , Masculino , Pneumocystis carinii/isolamento & purificação , Pneumonia por Pneumocystis/complicações , Pneumonia por Pneumocystis/microbiologia , Pneumonia por Pneumocystis/patologiaRESUMO
INTRODUCTION: The management of a first episode of spontaneous pneumothorax is controversial and the best technique to be used as an initial intervention, aspiration or intercostal drainage, is still debated. PATIENTS AND METHODS: We present a retrospective case series during two and a half consecutive years describing the immediate management of spontaneous pneumothoraces, comparing aspiration versus thoracic drainage. RESULTS: One hundred and thirty-three clinical files from patients with spontaneous pneumothoraces were analyzed (17 primary and 116 secondary). The pneumothoraces were of varying size and different etiologies. Patients were initially treated with simple aspiration in 68 cases, with an immediate success rate of 37.5%, intercostal drainage in 49 cases, and by rest alone in 16 cases. CONCLUSION: In case of secondary pneumothorax, aspiration appeared to offer advantages as an initial strategy over intercostal drainage in terms of hospital stay (11 versus 22 days), and with significant effectiveness (37.5%).
