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Bilateral primary spontaneous pneumothorax (BPSP) is a rare condition, accounting for ∼1.6% of spontaneous pneumothoraces. Patients with primary spontaneous pneumothorax have typically low body weight. BPSP in overweight/obese patients is an exceptionally rare event. The present report describes a case of an otherwise-healthy 20-year-old male patie...
Context in source publication
Context 1
... emergency basis, the patient was managed with bilateral tube thoracostomy through the fifth intercostal spaces. During hospitalization, both lungs were gradually expanded; the use of continuous aspiration was necessary for a couple of days, in order to achieve complete expansion of the left lung (Fig. 2). Both chest tubes were removed on the fifth day of hospitaliza- tion. Next day the plain X-ray revealed recurrence of pneumo- thorax on the left side (Fig. 3). A chest tube was reinserted. Continuous suction was used and complete expansion of the left lung was succeeded. The tube was removed after 5 days; no recurrence took place at this time. During the next 3 days the patient remained under observation; serial physical ex- aminations and chest X-rays were normal and the patient was discharged ...
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Primary spontaneous pneumothorax during pregnancy is a very rare entity. We present a 37-year-old Caucasian woman with spontaneous pneumothorax during the 32nd week of her fourth pregnancy who was treated with intercostal chest drain and was followed up with chest ultrasound. The patient experienced two more episodes of recurrent pneumothorax durin...
Introduction:
The timing of surgical intervention in the management of spontaneous pneumothorax remains controversial. The aim of this multicenter review was to compare management strategies and outcomes in children with spontaneous pneumothorax.
Methods:
We retrospectively reviewed patients 10-19 years old in the Pediatric Health Information Sy...
Bilateral simultaneous or non-simultaneous primary spontaneous pneumothorax (PSP) is a rare but serious condition. It has no unique risk factor, with a variable clinical presentation ranged from mild chest pain to severe fatal respiratory distress. The plans for management of bilateral PSP include symptomatic conservative treatment, chest drainage,...
Objective
This is a retrospective study of adverse events associated with preoperative computed tomography (CT)–guided hookwire or coil localisation. We analysed the experience and process flaws in resecting ground-glass nodules (GGNs) through video-assisted thoracoscopic surgery (VATS) and determined the remedial strategy.
Methods
Adverse events...
Background:
Primary spontaneous pneumothorax (PSP) is a spontaneous pneumothorax without underlying lung disease. The main goals of this study were to compare the outcomes of video-assisted thoracoscopic surgery (VATS) and open thoracotomy in patients with PSP.
Methods:
The current study is a retrospective cohort study of patients who were admit...
Citations
... However, pneumothorax can occur in patients who are centrally obese after receiving corticosteroids for some underlying diseases, such as obese patients with lung fibrosis who have been treated with corticosteroid for a long-term period. Difficulty in chest tube insertion in a very obese patients was reported previously (1,2). In a patient reported by Ledochowski et al, the anterior approach (from the surface of the anterior chest wall to the pleura) and lateral approach (from the surface of the lateral chest wall to the pleura) were 26.42 mm and 51.37 mm, respectively (1). ...
... However, subcutaneous emphysema occurred despite sufficient suturing of the puncture site. As reported in previous reports (1,2), chest tube insertion in very obese patients is very difficult. Special attention should be paid to complications. ...
... 7,8 However, most such support has arisen from small-sample studies of patients with bilateral pneumothorax with limited statistical power and generalizability. [7][8][9][10] Furthermore, few investigations of singlestage sequential thoracic surgery for bilateral pulmonary masses have been performed, and all such studies have lacked comparisons with two-stage bilateral thoracic surgery. [11][12][13] In addition, the decision to perform single-stage sequential bilateral thoracic surgery is usually made from a surgical point of view and seldom from a comprehensive evaluation. ...
Objective
Single-stage sequential bilateral video-assisted thoracoscopic surgery (VATS) is a controversial procedure. In the present study, we retrospectively compared the outcomes of single-stage and two-stage VATS.
Methods
This study involved patients who underwent single-stage sequential bilateral VATS (SS-VATS group) or two-stage VATS at a 3-month interval (TS-VATS group) for treatment of non-small cell lung cancer from 2010 to 2018. The major outcome was the comparison of intraoperative changes.
Results
The inspiratory peak pressure was higher, the incidences of intraoperative hypoxia and unstable hemodynamics were higher, the surgical time was longer, and the durations of the intensive care unit stay and postoperative hospitalization were longer in the SS-VATS group than in the TS-VATS group. However, the chest tube duration, incidence of postoperative mechanical ventilation, and clinical complications were not different between the two groups.
Conclusions
Compared with two-stage VATS, single-stage sequential bilateral VATS can be performed for successful treatment of bilateral pulmonary lesions with a shorter total time and higher cost-effectiveness in terms of anesthesia and hospitalization but with a higher incidence of intraoperative adverse effects and a longer hospital stay.
... Primary spontaneous pneumothorax (PSP) occurs with no underlying lung disease, usually in young, tall, thin, smoker male patients [1]. Most of the cases with PSP are unilateral, with a rare presentation of bilateral PSP in 1 -1.5% of all cases with spontaneous pneumothorax [2,3]. ...
... In cases with simultaneous bilateral PSP, lower BMI and the presence of bilateral blebs/bullae have statistically significant importance [4]. However, bilateral PSP has been reported in overweight/obese patients [1]. Also, the history of smoking, illicit drug use, toxic exposure, and significant medical or surgical history may be absent [2,7]. ...
... However, this is not the plan in cases of bilateral PSP as drainage of one side is indicated regardless of the extent of pneumothorax, with management of the other side in accordance to the extent of pneumothorax [1]. After chest drainage, computed tomography (CT) should be obtained to determine the presence of underlying blebs/bullae, and to direct the decision-making for further interventions. ...
Bilateral simultaneous or non-simultaneous primary spontaneous pneumothorax (PSP) is a rare but serious condition. It has no unique risk factor, with a variable clinical presentation ranged from mild chest pain to severe fatal respiratory distress. The plans for management of bilateral PSP include symptomatic conservative treatment, chest drainage, and single-stage or staged surgery. In terms of reduced post-operative pain and better visualization of thoracic cavity, the video-assisted thoracoscopic surgery (VATS) is a preferred procedure over open thoracotomy. A debate exists about the utility of bilateral VATS for non-simultaneous cases, first side to operate, placement of intercostal drains, patient re-positioning, and the use of single versus multiple incisions. There may be a need for respiratory and circulatory support during operations. In a neonate, the resolution of bilateral PSP depends on the availability of oxygen-enriched atmosphere.
Background:
Simultaneous bilateral primary spontaneous pneumothorax (SBPSP) is an extremely rare and potentially fatal condition. Patients usually have no relevant medical conditions. Some cases, however, may have certain risk factors such as smoking, being young, and male gender. We reported a case of a healthy young male who presented with BPSP.
Case presentation:
A 21-year-old man with a past medical history of well-controlled intermittent asthma presented with acute worsening shortness of breath overnight. Chest X-ray performed showed bilateral large pneumothorax with significantly compressed mediastinum. Chest tubes were placed bilaterally with immediate clinical improvement. However, the chest tubes continued to have an air leak without full lungs expansion. Computed tomography scan without contrast of the chest revealed subpleural blebs in both upper lobes. The patient underwent bilateral video-assisted thoracoscopic surgery (VATS) with apical bleb resection, bilateral pleurectomy, and bilateral doxycycline pleurodesis. Biopsy of the apical blebs and parietal pleura of both lungs were negative for any atypical cells suspicious for malignancy or Langerhans cell histiocytosis. The patient had been doing well six months following surgery with no recurrence of pneumothorax.
Conclusion:
SBPSP is a rare and urgent condition that requires prompt intervention. In a young patient without any underlying disease, surgical intervention, such as VATS, is relatively safe and can be considered early.
