Bilateral Bronchial Anomaly: A Pathogenetic Factor in Spontaneous Pneumothorax

Abstract

Flexible fiberoptic bronchoscopy (FFB) was performed in 26 never-smokers with healed spontaneous pneumothorax (SP) with the aim of detecting and localizing any bronchial obstruction, including congenital anomaly. In a case-control study these patients were compared with a consecutive, randomly sampled, control group of 41 patients who were undergoing FFB for respiratory symptoms but who had not had a SP. In both groups the endobronchial anatomy with respect to such anomalies, which could be classified as disproportionate bronchial anatomy, an accessory bronchus, and/or a missing bronchus, was compared with normal anatomy. All except one of the 26 patients with SP but only four of the 41 control patients without SP had such bronchial anomalies bilaterally. This corresponds to an odds ratio of 231 (95% confidence interval, 24 to 880; p < 0.001). The significantly higher frequency of bilateral bronchial anomalies in never-smokers with SP suggests that a virtual prerequisite for the occurrence of SP has been found. However causal links between the probably congenital bronchial anomalies and SP have not yet been identified.

Spontaneous Pneumothorax Treatment Modalities: A Study of 48 Cases

“…[11,12] PSP sürecine distal havayolu inflamasyonu ve sigara kullanımı gibi dış ve bronşiyal bozukluklar gibi iç faktörlerin yer aldığına inanılmaktadır. [13,14] Distal hava yolu tıkanıklığı blep, amfizem benzeri değişiklik-lerin gelişmesine neden olabilir. Bleb ve bül gelişimi ile plevral alandaki gözeneklilik, herediter yatkınlık, bronşial ağacın anatomik anomalileri, ektomorfik fizyonomi ile yüksek negatif intraplevral basınç, apikal iskemi, düşük vücut kitle endeksi ve kalori kısıtlaması ve bağ dokusu anomalileri arasında bağlantı olduğu düşünülmektedir.…”

“…Bleb ve bül gelişimi ile plevral alandaki gözeneklilik, herediter yatkınlık, bronşial ağacın anatomik anomalileri, ektomorfik fizyonomi ile yüksek negatif intraplevral basınç, apikal iskemi, düşük vücut kitle endeksi ve kalori kısıtlaması ve bağ dokusu anomalileri arasında bağlantı olduğu düşünülmektedir. [15][16][17][18][19][20][21] Sigara SP için önemli bir risk faktörüdür. Pnömotoraks gelişme olasılığı sigara içen erkeklerde %12 iken, içmeyenlerde %0.1'dir.…”

Spontaneous Pneumothorax: A Retrospective Study of Twenty-Five Patients and Literature Review

“…7 An in-depth study of our patient population with SP without underlying disease states (9/25 or 36%) such as with CT scan, flexible bronchofiberscopy or thoracoscopy might have revealed more underlying causes, as was observed by others. 4,11,12 CT of the lung is a sensitive test for the detection of early emphysematous changes, blebs and bullae when compared to conventional radiographs. 13 CT of the lung may also be useful in predicting the natural history of SP, but the same authors cannot recommend such an expensive test for routine use.…”

“…4 The Asir region of Saudi Arabia is a mountainous territory of about one million people, served by the Asir Central Hospital (ACH), a 450-bed tertiary hospital. Over a period of three years and nine months (1990)(1991)(1992)(1993)(1994), 25 patients were treated for spontaneous pneumothorax (SP) at ACH.…”

Clinical and paraclinical symptoms of primary spontaneous pneumothorax

“…Il a été souvent supposé que l'effort physique pouvait favoriser la survenue d'un pneumothorax spontané. Cependant, cette relation n'a jamais été vraiment confirmée [11,14].…”