Duration of pneumothorax as a complication of CT-guided lung biopsy

The purpose of this study was to determine management guidelines for biopsy-induced pneumothorax with the assistance of manual aspiration, mainly based on the duration of complicated pneumothorax. Data from 388 consecutive percutaneous needle lung biopsies were examined. Patients with pneumothorax on postbiopsy chest CT images underwent percutaneous manual aspiration with an 18-G i.v. catheter. Frequency and management of biopsy-induced pneumothorax and period to its disappearance were reviewed. Postbiopsy pneumothorax occurred in 133 of 388 (34.3%) procedures. Manual aspiration in 72 of these 133 patients was carried out immediately after biopsy. The pneumothorax had resolved completely on follow-up chest radiographs without chest tube placement in 121 of the 133 pneumothoraces (91.0%). In cases requiring chest tube, the mean period from biopsy until resolution of the pneumothorax was 6.0 ± 5.3 days, but was only 2.4 ± 2.9 days when chest tube placement was not needed. Specifically, time until recovery was short both in those not requiring manual aspiration (2.1 ± 3.4 days) and in those with a pneumothorax that disappeared completely or almost completely after manual aspiration (1.9 ± 2.0 days). The almost equally short recovery periods in patients not requiring manual aspiration and those requiring immediate manual aspiration indicates the value of rapid management