Larson Ryan
Private Practice, Elmira ON.
J Can Chiropr Assoc. 2016 Mar;60(1):66-72.
To present a case of primary spontaneous pneumothorax presenting to a chiropractic clinic as undifferentiated thoracic spine pain.
A tall thin 25-year-old male anxiously presented to a chiropractic clinic with six days of sudden unexplained left thorax pain. His breathing was laboured and his dry cough aggravating. After assessment a high clinical suspicion of primary spontaneous pneumothorax prevailed.
The patient was referred to hospital for further investigation and primary spontaneous pneumothorax was confirmed on chest radiograph. He underwent immediate tube thoracostomy to drain the air from his pleural space and to re-inflate his lung. After three days the tube was removed. By two weeks the lung had returned to full size. No recurrences have occurred to date.
Primary spontaneous pneumothorax is a medical emergency in the presence of shortness of breath. The focus of treatment is to drain air from the pleural linings and to prevent recurrences. In less severe cases, patients may believe they have thoracic spine pain and seek manual therapy care. This case highlights the important role chiropractors have as primary contact health care providers.
介绍一例以未分化型胸椎疼痛形式就诊于整脊诊所的原发性自发性气胸病例。
一名25岁瘦高男性，因突发不明原因的左侧胸痛6天，焦虑地前往整脊诊所就诊。他呼吸费力，干咳加重。经评估后，高度怀疑为原发性自发性气胸。
患者被转诊至医院进一步检查，胸部X光片确诊为原发性自发性气胸。他立即接受了胸腔闭式引流术，以排出胸腔内的气体并使肺部复张。三天后拔除引流管。两周后肺部恢复至正常大小。迄今为止未再复发。
出现呼吸急促时，原发性自发性气胸属于医疗急症。治疗的重点是排出胸膜腔内的气体并预防复发。在病情较轻的情况下，患者可能认为自己患有胸椎疼痛并寻求手法治疗。该病例凸显了整脊师作为初级接触医疗服务提供者所发挥的重要作用。
