Management of primary spontaneous pneumothorax in teenagers: An 11‐year study

Abstract

Idiopathic or primary spontaneous pneumothorax (PSP) is the accumulation of air in the pleural space that is not triggered by any trauma or invasive procedure, mechanical ventilation or pulmonary infection. 1 PSP prevalence is estimated between 16 and 52 cases per 100,000 persons, with most cases noted before the age of 23 years, and more particularly in tall and fine male adolescents around 16.3 years. 2 Diagnosis of PSP is usually evident, but the underlying pathophysiology is still hypothetic, and the best management to adopt is clearly not consensual. [2][3][4][5][6][7] Procedures regarding early diagnosis, chest CT-scan indication, therapy, and PSP recurrence prevention are highly variable and centre dependent, particularly in paediatric patients. In adults, guidelines, like that of the British Thoracic Society

Conservative and operative management of spontaneous pneumothorax in children and adolescents: Are we abusing of CT?

“…In such subsets, two individuals underwent an additional pleurodesis (one During the follow-up, 24 patients (39%) experienced ipsilateral recurrence and nine (14%) had contralateral occurrences. Conservative and operative groups showed no statistically significant differences regarding ipsilateral recurrence (31% [10], vs. 48% ( 14), p = .199) or contralateral occurrences (9% [3] vs. 20% [6], p = .287).…”

“…While it has been reported that the finding of blebs/bullous lesions on CT is an indication for surgery, 9 some authors have reported that these are not predictive of outcome or recurrence. 8,10,11 However, some authors reserve a role for CT in selected cases. 10,12 Others reported even a useless overuse by clinicians.…”

“…8,10,11 However, some authors reserve a role for CT in selected cases. 10,12 Others reported even a useless overuse by clinicians. 10 The aim of the present study was to analyze the management of spontaneous pneumothorax in children and adolescents, with particular emphasis on the role of conservative management in asymptomatic/paucisymptomatic patients.…”

“…10,12 Others reported even a useless overuse by clinicians. 10 The aim of the present study was to analyze the management of spontaneous pneumothorax in children and adolescents, with particular emphasis on the role of conservative management in asymptomatic/paucisymptomatic patients. Additionally, we wanted to review the role of the CT versus video-assisted thoracic surgery (VATS), focusing on their impact and value on outcomes and recurrence.…”

“…CT is not routinely performed in pediatric SP, and its role is not yet clear. While it has been reported that the finding of blebs/bullous lesions on CT is an indication for surgery, 9 some authors have reported that these are not predictive of outcome or recurrence 8,10,11 . However, some authors reserve a role for CT in selected cases 10,12 .…”