A 35-year-old tall, thin man presents with sudden onset right-sided pleuritic chest pain and mild dyspnea while playing cricket. Chest X-ray shows a visible visceral pleural line with absent lung markings peripherally. The rim of air measures 3 cm at the level of the hilum. What is the appropriate management?
- A Observation with high-flow oxygen
- B Intercostal tube drainage with Heimlich valve
- C Simple aspiration ✓
- D Chemical pleurodesis
Correct answer: C. Simple aspiration
Explanation
This is a primary spontaneous pneumothorax (tall, thin, young male) with a large rim (>2 cm at hilum per BTS guidelines). BTS 2023 guidelines recommend simple aspiration as first-line for large primary PSP, which is successful in about 60% of cases. If aspiration fails, intercostal drainage is indicated. Observation is for small pneumothoraces. Chemical pleurodesis is reserved for recurrent cases.
Reference: British Thoracic Society Pleural Disease Guideline, 2023 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.