The use of computed tomography to assess and treat complex pneumothorax

: A complex pneumothorax is a loculated pneumothorax due to adhesions. Chest roentgenograms are usually inadequate to assess a complex pneumothorax. A computed tomography (CT) scan can be used to accurately assess the extent of the pneumothorax, and to determine its exact location in order to make placement of a tube thoracostomy easier and safer. In addition, if there is a persistent or recurrent pneumothorax after tube thoracostomy, a CT scan can be used to determine the relationship of the chest tube to the pneumothorax. Three cases are discussed to illustrate the use of the CT scan in evaluating patients who have a complex pneumothorax.