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The management of pneumothoraces has increasingly moved towards less-invasive interventions, such as small-diameter pigtail catheters, needle aspiration, and observation. Guidelines recommend observation for small spontaneous pneumothoraces and occult traumatic pneumothoraces; however, there is increasing interest in foregoing drainage of nonoccult traumatic pneumothoraces. Prior studies suggest a pneumothorax size of 35 mm as a cutoff for deciding which patients can be managed with observation.
In a single-center chart review of 336 patients with traumatic pneumothoraces who were initially managed with observation, researchers compared outcomes between patients with pneumothoraces ≤35 mm and >35 mm in size. Nearly all patients had a blunt m…