11th January 2024

A 77-year-old gentleman is on the respiratory ward following a 3.5cm secondary spontaneous pneumothorax in the community 5 days ago on a background of interstitial lung disease.

A 77-year-old gentleman is on the respiratory ward following a 3.5cm secondary spontaneous pneumothorax in the community 5 days ago on a background of interstitial lung disease. An intercostal drain was inserted at admission, which helped resolve his symptoms; however, the pneumothorax has failed to resolve fully. He has received suction at -20cmH20 for the last 48 hours. An x-ray today confirms he currently still has a 2cm pneumothorax. 

What is the single most appropriate next step in his management strategy? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.