Outpatient management of primary spontaneous pneumothorax

The outpatient management of primary spontaneous pneumothorax (PSP) is still debated. The risk of a tension pneumothorax is used to justify active treatment like chest-tube drainage, although outpatient management can reduce both the time in hospital and the cost of treatment. It is also likely to be the patient's choice. This report is a reappraisal of the situations for which outpatient management, by monitoring alone, or using minimally invasive techniques, can be considered. •While exclusive outpatient care of PSP is the exception, more and more studies provide evidences supporting such management.•Minimally invasive techniques are easy of use, and their related adverse events are scarce.•In some conditions, the air need not be evacuated from the pleural space; the decision should be based on the patient's clinical tolerance.•Ambulatory management of PSP are only safe if the patient clearly understands the issues involved and follows a rigorous monitoring protocol.