Abstract
Background. Simultaneous bilateral pneumothorax is a rare condition. Very rarely, it may develop through a communication between the two sides of the thoracic cavity. Case. A 69-year-old man who had undergone resection of an esophageal carcinoma had difficulty in breathing and underwent a medical examination. He experienced a simultaneous bilateral pneumothorax, underwent bilateral chest drainages, and was hospitalized. Because of the simultaneous bilateral pneumothorax and continued air leak, an operation was performed. Results. First, thoracoscopic bullectomy was performed from the right side. At the time of changing the position, the water poured in the right thoracic cavity to test for air leaks flowed out to the left drain in large quantities; thus, a communication between the two sides of the thoracic cavity became clear. On the left side, thoracoscopic bullectomy and coverage with a polyglycolic acid sheet and fibrin glue of the mediastinal pleura, which seemed to be defective and caused suspicion of a hole between the thoracic cavities without clearly revealing any mediastinal window, were performed. Conclusion. Prevention of recurrence is important in cases of simultaneous bilateral pneumothorax; thus, it is necessary to search for a mediastinal window and close it if it exists. In addition, a preoperative strategy is also necessary when no mediastinal window is found.
