Diagnóstico, seguimiento y tratamiento guiado por ultrasonografía del neumotórax residual posquirúrgico. Reporte de caso

Abstract

Residual pneumothorax after chest surgery is common. Once it has been verified that the chest tube is working correctly, treatment consists of performing respiratory physiotherapy to achieve complete lung expansion. The objective of this study is to demonstrate the use of ultrasonography as an accurate and real-time tool to monitor lung re-expansion and resolve the pleural space in patients with residual pneumothorax after thoracic surgery. Two cases of post-surgical residual pneumothorax are reported, monitored by serial lung ultrasounds before and after respiratory physiotherapy interventions.

Case 1: A 68-year-old female patient developed a right pneumothorax and posterior empyema after the placement of a nasojejunal tube, requiring chest surgery. Ultrasound-guided respiratory physiotherapy was performed, resulting in complete post-surgical lung re-expansion.

Case 2: A 49-year-old male patient, a cyclist, sustained multiple rib and clavicle fractures, leading to a left pneumothorax. Postoperative ultrasound-guided physiotherapy interventions were conducted, resulting in full lung re-expansion.

Ultrasound effectively identified residual pneumothorax and guided respiratory physiotherapy intervention, achieving complete lung re-expansion in both cases. This approach reduced the need for additional radiographs and minimized radiation exposure.