{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:03:30Z","timestamp":1756339410284,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,6,14]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>An 85-year-old ex-smoker being managed conservatively over 2\u2009years for a small right apical pneumothorax presented to the respiratory clinic with suddenly worsening shortness of breath and chest pain. A chest radiograph demonstrated sudden deterioration in the size of his pneumothorax. Previous CT scans had found emphysematous cystic changes within the lungs, and his new presentation warranted definitive surgical intervention with a right bullectomy and talc pleurodesis through a video-assisted thoracoscopic surgery procedure. The patient made a good recovery and was discharged from clinic a year later. This case demonstrates the importance of follow-up in patients with unresolved pneumothoraces due to the potential for sudden deterioration, and highlights the significance of respecting patient involvement and autonomy in the decision-making process.<\/jats:p>","DOI":"10.1136\/bcr-2021-243556","type":"journal-article","created":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T11:55:14Z","timestamp":1625745314000},"page":"e243556","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Requirement of interventional treatment in a patient being conservatively managed for persistent pneumothorax over a prolonged period"],"prefix":"10.1136","volume":"14","author":[{"given":"Sophia","family":"Brenac","sequence":"first","affiliation":[{"name":"Keele University School of Medicine, Keele, Staffordshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nawaid","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Shrewsbury and Telford Hospitals NHS Trust, Telford, Shropshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"key":"2025082701485559000_14.7.e243556.1","article-title":"Epidemiology of pneumothorax: UK national primary care data (1995-2015)","volume":"50","author":"Hallifax","year":"2017","journal-title":"European Respiratory Journal"},{"key":"2025082701485559000_14.7.e243556.2","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00005310"},{"key":"2025082701485559000_14.7.e243556.3","doi-asserted-by":"publisher","DOI":"10.1378\/chest.92.6.1009"},{"key":"2025082701485559000_14.7.e243556.4","doi-asserted-by":"crossref","DOI":"10.1183\/09031936.93.04030324","article-title":"Independent risk factors for cumulative recurrence rate after first spontaneous pneumothorax","volume":"4","author":"Lippert","year":"1991","journal-title":"Eur Respir J"},{"key":"2025082701485559000_14.7.e243556.5","first-page":"365","article-title":"Spontaneous pneumothorax in chronic obstructive pulmonary disease: complications, treatment and recurrences","volume":"71","author":"Videm","year":"1987","journal-title":"Eur J Respir Dis"},{"key":"2025082701485559000_14.7.e243556.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.12.019"},{"key":"2025082701485559000_14.7.e243556.7","doi-asserted-by":"crossref","first-page":"313","DOI":"10.2214\/ajr.166.2.8553937","article-title":"Comparison of upright inspiratory and expiratory chest radiographs for detecting pneumothoraces","volume":"166","author":"Seow","year":"1996","journal-title":"AJR Am J Roentgenol"},{"key":"2025082701485559000_14.7.e243556.8","first-page":"ii18","article-title":"Management of spontaneous pneumothorax: British thoracic Society pleural disease guideline 2010","volume":"65 Suppl 2","author":"MacDuff","year":"2010","journal-title":"Thorax"},{"key":"2025082701485559000_14.7.e243556.9","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1056\/NEJMoa1910775","article-title":"Conservative versus interventional treatment for spontaneous pneumothorax","volume":"382","author":"Brown","year":"2020","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025082701485559000_14.7.e243556.10","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2006.037143"},{"key":"2025082701485559000_14.7.e243556.11","doi-asserted-by":"publisher","DOI":"10.1136\/thx.21.2.145"},{"key":"2025082701485559000_14.7.e243556.12","doi-asserted-by":"crossref","first-page":"809","DOI":"10.7326\/0003-4819-72-5-809_4","article-title":"Spontaneous pneumothorax in emphysema","volume":"72","author":"Dines","year":"1970","journal-title":"Ann Intern Med"},{"key":"2025082701485559000_14.7.e243556.13","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1111\/ggi.13996","article-title":"Etiology and prognosis of spontaneous pneumothorax in the elderly","volume":"20","author":"Takahashi","year":"2020","journal-title":"Geriatr Gerontol Int"},{"key":"2025082701485559000_14.7.e243556.14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1975.03260170025019"},{"key":"2025082701485559000_14.7.e243556.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.thorsurg.2009.02.003"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243556","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:49:06Z","timestamp":1756284546000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243556"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":15,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7,8]]},"published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1136\/bcr-2021-243556"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243556","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}