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Objective: To determine the incidence of iatrogenic pneumothorax caused by various diagnostic procedures in our center and to investigate its impact on morbidity.
Methods: The outcomes of 418 invasive procedures performed between September 2000 and January 2001 were analyzed. The procedures were thoracentesis in 133 cases, computed tomography (CT) guided transthoracic fine needle aspiration (TFNA) in 123 cases, pleural biopsy in 84 cases, fluoroscopy guided TFNA in 42 cases, transbronchial biopsy in 30 cases and cutting-needle biopsy in 6 cases.
Results: Iatrogenic pneumothorax was identified in 32 cases. Incidence of iatrogenic pneumothorax was 13% for CT guided TFNA, 7.1% for pleural biopsy, 16.6% for transbronchial biopsy, 7.1% for fluoroscopy guided TFNA and 1.5% for thoracentesis. The pneumothorax was minimal in 12 cases, small in 11 cases, moderate in 5 cases, complete in 2 cases. Hydropneumothorax was identified in 2 cases. Twenty cases were followed by observation only, 7 cases received supplemental oxygen and a chest tube with underwater seal was inserted in 5 cases. One patient who underwent chest tube drainage after pleural biopsy died.
Conclusions: The leading causes of iatrogenic pneumothorax are transbronchial lung biopsy and CT-guided transthoracic fine needle aspiration. Iatrogenic pneumothorax is an important cause of morbidity, may cause prolonged hospital stay and may result in death.