Simultaneus Bilateral Spontaneus Pneumothoraces: a Retrospective Analysis of 11 Cases

Abstract

Aim Spontaneous pneumothorax (SP) is relatively common in clinical practice and occurs more frequently in young, tall thin men, and in smokers. However, simultaneous bilateral spontaneous pneumothorax (SBSP) is a rare clinical condition that often presents with significant respiratory distress. It is often dangerous; therefore, the chest drain should be inserted immediately. In this study, simultaneus bilateral spontaneus pneumothoraces cases were divided into two groups and retrospectively evaluated according to age, sex, diagnostic methods, treatments, and results. Material and Methods Between January 2006 and May 2009, 11 patients with SBSP were enrolled into our study. Age, gender, underlying lung disease, smoking history, symptoms, diagnosis, treatment type, surgical indication, morbidity, recurrence, mortality, duration of chest tube and postoperative hospital stay of the patients were reviewed. Arterial blood gas values (before and after intervention) in patiens with primary and secondary spontaneous pneumothorax were evaluated. Results 7 patients (63.63 %) were male and 4 patients (36.37 %) were female and their mean age was 34,5 +/- 6.81 years. There were 4 (36.37%) primary SP and 4 (36.37%) secondary SP patients. Chronic obstructive pulmonary disease (COPD) was the most common cause in secondary SP patients. In two (18.18%) patients recurrency were observed. Eight (72.72%) patients had smoking history. The most common symptom in both groups was dyspnea. All patients had immediate bilateral chest tubes on admission. We treated these patients with chest drain insertion, VATS (Video-Assisted Thoracoscopic Surgery), axillary thoracotomy, and chemical pleurodesis. Postoperative morbidity was detected in 3 (27.27%) patients (prolonged air leak in 1 case, empyema in 1 case and pneumonia in 1 case). No mortality was observed in alll cases. Recurrence developed in 3 (27.27%) patients in this series. Conclusions An urgent and effective treatment requires in the patients with SBSP. We think that tube drainage can be appropriate and effective for most cases of SBSP. Surgical procedures can be applied safely, with low recurrence rate, when the tube thoracostomy remains unsuccessful and/or SP recurs.