[Management of pneumothorax].

Pneumothorax is a common disease in emergency medicine. It is a medical problem requiring prompt treatment and often hospitalization. Primary spontaneous pneumothorax (PSP) pathophysiology is related to emphysematous lung changes and smoking (dose dependent). Requirement for air removal depends on the size and tolerance of PSP. Chest tube drainage (CTD) can be replaced by a less traumatic approach (needle aspiration and, in case of failure, small tube connected to a one-way valve), so that less than 50% of patients with PSP need to be hospitalised. Unlike PSP, pneumothoraces associated with underlying lung diseases usually require CTD since needle aspiration is less successful in theses cases. Pleurodesis aims to prevent recurrences (about 30% of PSP) and can be obtained either with talc poudrage, pleural abrasion or surgical pleurectomy.