TY - JOUR
T1 - Simultaneous bilateral primary spontaneous pneumothorax
AU - Lee, Shih Chun
AU - Cheng, Yeung Leung
AU - Huang, Chi Wang
AU - Tzao, Ching
AU - Hsu, Hsian He
AU - Chang, Huang
PY - 2008/1
Y1 - 2008/1
N2 - Objective: While primary spontaneous pneumothorax (PSP) is common in adolescents and young adults, simultaneous bilateral PSP (SBPSP) is rare and can be life-threatening if it progresses to tension pneumothorax. This study reviewed cases of PSP to identify the clinical features of SBPSP. Methods: All patients with PSP diagnosed and treated between June 1996 and June 2006 were reviewed, and the clinicoradiological features and outcomes were evaluated. Results: Of the 616 patients with 807 episodes of PSP, 13 had SBPSP (1.6%) at first presentation, and all were male (mean age 20.9 ± 4.7 years, range 16-25 years). Compared with the non-SBPSP patients, SBPSP patients had significantly lower body weight and BMI (P = 0.018 and <0.001, respectively) and higher body height/body weight ratio (P = 0.004). There was no significant difference in their age, sex, smoking habits or body height. Patients with SBPSP had a significantly higher incidence of bleb/bullae seen in HRCT of the lung compared with non-SBPSP (88.5% vs 63.5%, P = 0.016). In multiple logistic regression analysis, BMI and presence of blebs/bullae were independent risk factors for SBPSP. All patients with SBPSP received bilateral video-assisted thoracoscopic surgery and recovered uneventfully. The mean follow-up period was 3.7 years (range 10 months-7 years). Conclusion: Patients with PSP having a lower BMI, and bilateral bleb/bullae formation are at higher risk for the development of SBPSP. SBPSP needs urgent assessment and management, and bilateral video-assisted thoracoscopic surgery is a safe and effective treatment.
AB - Objective: While primary spontaneous pneumothorax (PSP) is common in adolescents and young adults, simultaneous bilateral PSP (SBPSP) is rare and can be life-threatening if it progresses to tension pneumothorax. This study reviewed cases of PSP to identify the clinical features of SBPSP. Methods: All patients with PSP diagnosed and treated between June 1996 and June 2006 were reviewed, and the clinicoradiological features and outcomes were evaluated. Results: Of the 616 patients with 807 episodes of PSP, 13 had SBPSP (1.6%) at first presentation, and all were male (mean age 20.9 ± 4.7 years, range 16-25 years). Compared with the non-SBPSP patients, SBPSP patients had significantly lower body weight and BMI (P = 0.018 and <0.001, respectively) and higher body height/body weight ratio (P = 0.004). There was no significant difference in their age, sex, smoking habits or body height. Patients with SBPSP had a significantly higher incidence of bleb/bullae seen in HRCT of the lung compared with non-SBPSP (88.5% vs 63.5%, P = 0.016). In multiple logistic regression analysis, BMI and presence of blebs/bullae were independent risk factors for SBPSP. All patients with SBPSP received bilateral video-assisted thoracoscopic surgery and recovered uneventfully. The mean follow-up period was 3.7 years (range 10 months-7 years). Conclusion: Patients with PSP having a lower BMI, and bilateral bleb/bullae formation are at higher risk for the development of SBPSP. SBPSP needs urgent assessment and management, and bilateral video-assisted thoracoscopic surgery is a safe and effective treatment.
KW - Bilateral
KW - Bulla
KW - Primary spontaneous pneumothorax
KW - Video-assisted thoracoscopic surgery
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U2 - 10.1111/j.1440-1843.2007.01168.x
DO - 10.1111/j.1440-1843.2007.01168.x
M3 - Review article
C2 - 18197926
AN - SCOPUS:38049107781
SN - 1323-7799
VL - 13
SP - 145
EP - 148
JO - Respirology
JF - Respirology
IS - 1
ER -