2008 Volume 22 Issue 7 Pages 1067-1071
We report a patient showing an initial episode of primary spontaneous pneumothorax occurring bilaterally and simultaneously, which is rare in young females, treated with an immediate VATS bullectomy. The patient was a premenarcheal 14-year-old girl. Human growth hormones had been prescribed by another physician to improve her short stature. One month before admission, she experienced chest pain, which improved without any medication. She presented to her physician with a 4-day history of coughing, was diagnosed with bilateral pneumothorax, and was referred to our hospital. A chest radiograph obtained on admission showed collapsed lungs of Kircher class III on the right and class II on the left. On the same day, we performed bilateral chest tube drainage. One day later, chest CT-scan was conducted after a chest radiograph confirmed that both lungs had re-expanded. It revealed bilateral lung bullae which were limited to the apex, but no evidence of diffuse lung disorders. She was diagnosed with primary spontaneous pneumothorax, and, on the third hospital day, bilateral VATS was performed with the patient in the lateral position. Pathological examination of the resected lung specimens revealed subpleural bullae and emphysematous changes in adjacent lung parenchyma. The chest tubes were removed one day after the operation, and she was discharged on the fourth postoperative day.
