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. 2010 Apr;42(1):5-8.
doi: 10.5152/eajm.2010.02.

Simultaneous bilateral spontaneous pneumothorax: a rare emergency clinical condition

Yener Aydin  1 , Atila Turkyilmaz  2 , Yavuz Selim İntepe  3 , Atilla Eroglu  2
Affiliations

Simultaneous bilateral spontaneous pneumothorax: a rare emergency clinical condition

Yener Aydin et al. Eurasian J Med. 2010 Apr.

Abstract
in English, Turkish

Objective: Spontaneous pneumothorax is a disease that may cause serious respiratory distress and can be a life-threatening condition. A total of 1.3% of all spontaneous pneumothorax cases are simultaneous bilateral spontaneous pneumothorax (SBSP). In this study, because of its rarity, we discuss SBSP cases in light of previously reported cases.

Materials and methods: Between January 2004 and December 2009, SBSP was detected in five patients.

Results: All patients were male, and the mean patient age was 18.6 (between 16 and 22 years of age). All patients had various degrees of dyspnea and chest pain. All diagnoses were established by chest X-rays. Two patients (40%) had primary spontaneous pneumothorax (PSP), and three (60%) had secondary spontaneous pneumothorax (SSP) (two patients had silicosis, and one had Staphylococcus aureus pneumonia). Previously, bilateral tube thoracostomies were performed on all patients. One PSP patient had a left apical pleurectomy with axillary thoracotomy; the other had a right apical pleurectomy. Tetracycline pleurodesis was performed on one of the silicosis patients. No additional surgical procedure or pleurodesis was performed on the other silicosis patient or on the pneumonia patient. No recurrence of pneumothorax was observed in any patient.

Conclusions: SBSP could be a life-threatening condition; therefore, urgent diagnosis and appropriate treatment of this condition can save patients' lives.

Amaç: Spontan pnömotoraks ciddi solunum sıkıntısına yol açabilen ve bazen hayati tehlike arzedebilen bir hastalıktır. Tüm spontan pnömotoraks olgularının 1,3%’ünü eş zamanlı bilateral spontan pnömotoraks (EBSP) oluşturmaktadır.

Gereç ve yöntem: Ocak 2004 ve Aralık 2009 tarihleri arasında 5 hastada EBSP tespit edildi.

Bulgular: Hastaların hepsi erkek olup ortalama yaş 18,6 (16–22 yaş arası) idi. Hastaların hepsinde çeşitli derecelerde dispne ve göğüs ağrısı mevcuttu. Tanı bütün vakalarda PA akciğer grafisi ile netleştirildi. İki (40%) hastada primer spontan pnömotoraks (PSP), üç (60%) hastada ise sekonder spontan pnömotoraks (SSP) (2 hastada silikozis, 1 hastada staf aureus pnömonisi) mevcuttu. Tüm olgulara öncelikle bilateral tüp torakostomi uygulandı. Primer spontan pnömotorakslı hastalardan birine aksiller torakotomi ile sol apikal plörektomi, diğerine ise sağ apikal plörektomi uygulandı. Silikozisli bir olguya tetrasiklin ile plöredez uygulandı. Diğer silikozis olgusu ve pnömonili olguya ek cerrahi işlem veya plöredez uygulanmadı. Hastaların hiçbirinde pnömotoraks nüksü gözlenmedi.

Sonuç: EBSP hayatı tehdit edici bir durum olup acil teşhis ve uygun tedavi hayat kurtarıcıdır.

Keywords: Primary; secondary; simultaneous bilateral spontaneous pneumothorax.

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Figures

Figure 1.
Figure 1.
Posteroanterior chest radiography showing simultaneous bilateral pneumothorax in case 1
Figure 2.
Figure 2.
Posteroanterior chest radiography showing bilateral insertion of the chest tube in case 1
Figure 3.
Figure 3.
Posteroanterior chest radiography of case 1 before discharge
See this image and copyright information in PMC

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