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Background Pneumothorax is the most common complication of computed tomography (CT)-guided lung biopsy. The asymptomatic rate ranges from 17.5 to 72%. The symptomatic rate requiring chest tube insertion is 6 to 18%. Aims This article studies the role of management of postbiopsy pneumothoraces by needle aspiration and pigtail catheter insertion. Methods This was a prospective observational study conducted over 2 years. Postbiopsy and prior to withdrawing the coaxial cannula a CT data set was obtained to detect and quantify pneumothoraces as mild, moderate, and severe. In all asymptomatic cases of mild pneumothorax simple observation was done. In all asymptomatic cases of moderate pneumothorax, immediate needle aspiration was performed. In all symptomatic cases, cases with severe pneumothorax, and cases with progressively enlarging pneumothorax small caliber 6 to 8F pigtail catheters were inserted. Results Ninety-one cases had mild pneumothorax, 42 had moderate pneumothorax, and 18 had severe pneumothorax. In the 91 patients of mild pneumothorax only 1 (1%) patient showed increase in size of pneumothorax on follow-up requiring catheter insertion. In the 42 cases of moderate pneumothorax, which were managed by simple aspiration of pneumothorax, 4 (9.5%) cases showed increase in size of pneumothorax on follow-up. A total 23 cases required pigtail catheter insertion in our study. These constituted 15.2% of pneumothorax cases. The mean duration of catheterization in our study was 3.74 ± 1.09 days. Conclusion Majority of pneumothoraces are benign and do not require any intervention, just observation. Manual aspiration is an effective way of treating moderate pneumothoraces with success rate of 90%, thereby reducing the number of cases requiring catheter insertion; however, close observation is required as few cases may progress to severe pneumothorax and require pigtail insertion. Only a small percentage of biopsy cases (6.4%) require catheter insertion which is a safe and effective treatment. [ABSTRACT FROM AUTHOR]

Background: CT Guided lung biopsy is a common procedure in our department and pneumothorax is one of its commonest complications. To study the incidence of pneumothorax after CT guided lung biopsy and the various factors associated with the risk of developing pneumothorax after biopsy. Materials and Methods: Our study was a retrospective observational study. We analyzed 360 cases of lung biopsy performed using 18G Coaxial needle for assessing the incidence of post-procedure pneumothorax. The risk factors for pneumothorax were evaluated by univariate analysis, followed by multivariate logistic regression analysis to know the independent risk factors of pneumothorax. Results: The incidence of pneumothorax in our study was 41.9% (151/360 cases). On univariate analysis, we identified the following as risk factors of post-procedure pneumothorax: the presence of emphysema, smaller lesion size, Greater lesion depth, Lateral position, multiple passes and acute angulation of needle trajectory. On multivariate logistic regression analysis these were also revealed to be independent risk factors of post-procedure pneumothorax. Conclusion: Independent risk factors of post procedure pneumothorax are the presence of emphysema, smaller lesion size, greater lesion depth, Lateral position, multiple passes and acute angulation of needle trajectory. Of these lateral position is a novel predictor of pneumothorax that has been scarcely mentioned in literature. As such the radiologist should be prepared for managing pneumothorax in cases with one or more of these risk factors. [ABSTRACT FROM AUTHOR]

Homocystinuria is a genetic inborn error of metabolism due to the deficiency of cystathionine β-synthase resulting in increased serum homocysteine and methionine and decreased cysteine which predisposes affected individuals to arterial and venous thromboembolic phenomena. We present a case of homocystinuria who presented to us as a calcified right atrial mass during the evaluation for lower respiratory tract infection. Our case reveals an unusual mix of findings using imaging with multiple detector computed tomography and radiographs. [ABSTRACT FROM AUTHOR]