{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:56:15Z","timestamp":1760144175730,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Traumatic pneumothorax (PTX) occurs in up to 50% of patients with severe polytrauma and chest injuries. Patients with a traumatic PTX with clinical signs of tension physiology and hemodynamic instability are typically treated with an urgent decompressive thoracostomy, tube thoracostomy, or needle decompression. There is recent evidence that non-breathless patients with a hemodynamically stable traumatic PTX can be managed conservatively through observation or a percutaneous pigtail catheter. We present here a 52-year-old woman who presented to the emergency department with a 55 mm traumatic PTX. Following aspiration of 1500 mL of air, a clinical improvement was immediately observed, allowing the patient to be discharged shortly thereafter. In hemodynamically stable patients with a post-traumatic PTX, without specific risk factors or oxygen desaturation, observation or simple needle aspiration can be a reasonable approach. Although the recent medical literature supports conservative management of small traumatic PTXs, guidelines are lacking for hemodynamically stable patients with a significantly large PTX. This case report documents our successful experience with needle aspiration in such a setting of large traumatic PTX. We aimed in this article to review the available literature on needle aspiration and conservative treatment of traumatic pneumothorax. A total of 12 studies were selected out of 190 articles on traumatic PTX where conservative treatment and chest tube decompression were compared. Our case report offers a novel contribution by illustrating the successful resolution of a sizable pneumothorax through needle aspiration, suggesting that even a large PTX in a hemodynamically stable patient, without other risk conditions, can be successfully treated conservatively with simple needle aspiration in order to avoid tube thoracostomy complications.<\/jats:p>","DOI":"10.3390\/medicina60040548","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T12:52:12Z","timestamp":1711630332000},"page":"548","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Successful Needle Aspiration of a Traumatic Pneumothorax: A Case Report and Literature Review"],"prefix":"10.3390","volume":"60","author":[{"given":"Giuseppe","family":"Bettoni","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Gheda","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Altomare","sequence":"additional","affiliation":[{"name":"Advanced Technologies in Surgery, Department of Surgical Sciences, University of Rome Sapienza, 00185 Rome, Italy"},{"name":"General Surgery Trauma Team, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5453-8901","authenticated-orcid":false,"given":"Stefano Piero Bernardo","family":"Cioffi","sequence":"additional","affiliation":[{"name":"Advanced Technologies in Surgery, Department of Surgical Sciences, University of Rome Sapienza, 00185 Rome, Italy"},{"name":"General Surgery Trauma Team, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Ferrazzi","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela","family":"Cazzaniga","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7650-5836","authenticated-orcid":false,"given":"Luca","family":"Bonacchini","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7874-2640","authenticated-orcid":false,"given":"Stefania","family":"Cimbanassi","sequence":"additional","affiliation":[{"name":"General Surgery Trauma Team, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy"},{"name":"Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6811-9305","authenticated-orcid":false,"given":"Paolo","family":"Aseni","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy"},{"name":"Department of Biomedical and Clinical Sciences \u201cL. Sacco\u201d, Universit\u00e0 degli Studi di Milano, 20157 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1111\/j.1440-1843.2004.00577.x","article-title":"Pneumothorax","volume":"9","author":"Baumann","year":"2004","journal-title":"Respirology"},{"key":"ref_2","unstructured":"American College of Surgeons (2018). ATLS: Advanced Trauma and Life Support. 10th Edition Student Course Manual, American College of Surgeons."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1016\/S0196-0644(85)80635-1","article-title":"The risk of percutaneous chest tube thoracostomy for blunt thoracic trauma","volume":"14","author":"Daly","year":"1985","journal-title":"Ann. Emerg. 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