2017 Volume 53 Issue 4 Pages 889-894
Purpose: Primary spontaneous pneumothorax (PSP) is relatively rare in children. The aim of this retrospective study was to review the clinical features of PSP and devise strategies for its appropriate treatment.
Methods: The medical records of all children aged 15 years and younger diagnosed with PSP between April 2006 and December 2011 were reviewed. We analyzed the records and extracted multiple medical parameters.
Results: Seven children (six boys and one girl; mean age of 14 years and 7 months) with PSP were found. Six of the seven patients were 15 years old. Four of the seven patients were initially treated with chest-tube drainage, and two had persistent air leak until surgery. All patients had an ectomorphic body type with no relevant past medical/family history. Computed tomography revealed definite multiple bullous lesions at the lung apex in all patients, and all underwent a surgical procedure (video-assisted thoracic surgery, VATS) at the initial presentation. Wedge resection (“bullectomy”) with pleurodesis was performed in all patients. No patient showed recurrent ipsilateral pneumothorax but four developed delayed contralateral PSP. Compared with adult patients with PSP treated in our hospital, the pediatric patients presented a more contralateral PSP after surgery (p＝0.0002).
Conclusions: We observed similar trends in gender predisposition and body habitus between children and adults with PSP. VATS was useful in pediatric cases. The risk of contralateral PSP after surgery was greater in children than in adults; therefore, careful follow-up is necessary.