Chest Imaging

Postbiopsy pneumothorax

a complication of thoracic percutaneous biopsy of the lung or pleura. It may occur after nonimage-guided pleural biopsy or needle biopsy of the lung, pleura or mediastinum using ultrasound, fluoroscopy or CT. Rates of pneumothorax after percutaneous biopsy vary between 10% and 25%. Most are very small and do not require treatment but approximately 10% will require tube drainage. The incidence is related to the depth of the lesion biopsied, the number of passes, the size and design of needle, the duration of the procedure, transgression of emphysematous lung or fissures and the skill of the operator. Maintaining the patient in a recumbent position lying on the biopsied side reduces the risk.

Postbiopsy pneumothorax may be evident immediately, but may not occur for several hours afterwards. Patients should therefore be observed for 4 hours and have a chest radiograph prior to discharge. Very rarely a delayed pneumothorax occurs up to 24 hours postbiopsy. Patients should be warned of this risk and advised of the need to seek appropriate help in such circumstances.

CF - HM