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

Abstract

We present a retrospective study of 25 patients with spontaneous pneumothorax (three recurrent), comprising 16 Saudis (nine males and seven females) and nine non-Saudis (eight males and one female), seen at the Asir Central Hospital, Abha, over a period of 45 months. Almost one-third of the patients (9/25) had no underlying cause discernible by our investigational facilities (chest x-ray, ultrasonography, computed tomographic scan, and flexible bronchofiberscopy). Underlying pneumonia (three patients), pulmonary tuberculosis (two patients), lung abscess (one patient), and congenital bullae (one patient) constituted the etiology in another third of the spontaneous pneumothorax patients. Other underlying pulmonary diseases precipitating spontaneous pneumothorax in the group included pulmonary fibrosis, metastatic mesothelioma, and immunosuppression in a medulloblastoma patient undergoing chemotherapy with the development of chickenpox. Closed thoracostomy tube drainage was the only method of treatment in 20 out of the 25 patients, with three failures of closed thoracostomy tube drainage needing thoracotomy and resection of blebs/bullae. The only complication was empyema in two of the patients. Two patients were successfully treated conservatively with observation alone. Ann Saudi Med 1996;16(3):249-253. A-N Batouk, S Jastaniah, IA Grillo, TS Malatani, AH Al-Saigh, MY Al-Shehri, B Teklu, A Softah, KA Mohmed Ali, Spontaneous Pneumothorax: a Retrospective Study of Twenty-Five Patients and Literature Review. 1996; 16(3): 249-253 The term pneumothorax was introduced almost two centuries ago by Itard in 1803, and popularized by Laennec in 1819.1 From that time until the mid-1930s, it was thought that all pneumothoraces were secondary to pulmonary tuberculosis.2 Kjaergaard's review of the subject in 1932 highlighted the occurrence of the condition in previously healthy individuals.3 If these "healthy individuals" had been thoroughly studied with modern medical, radiological or endoscopic investigations, they might have been found to have such occult abnormalities as blebs, bullae, or bronchial obstructions. 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. As this problem has not been previously reviewed in this part of the world, we are presenting the first 25 adult patients of SP seen in this region and reviewing the literature in light of our experience. Patients and MethodsTwenty-five patients with spontaneous pneumothorax (SP) constitute the subjects of this retrospective study (April .1990 to December 1994. The patients consisted of 16 Saudis and nine non-Saudis seen at ACH, either on direct admission through the Emergency Department or upon referral from neighboring hospitals and admitted or evaluated only as outpatients. The demographics (nationality, sex...

The Descriptive Features of Primary Spontaneous Pneumothorax Patients in King Abdulaziz Medical City, Riyadh, Saudi Arabia

“…Furthermore, the results showed that the highest proportion of patients were diagnosed with left PSP (43.5%), followed by right PSP (38.9%). This contradicts a previous study conducted with 25 patients in Saudi Arabia, which found that the ratio of right-to-left pneumothorax was 6:1, with only one bilateral pneumothorax documented [ 22 ]. Moreover, PSP recurrence was observed in 42% of sampled patients, with at least one recurrence for patients diagnosed with bilateral-simultaneous PSP.…”

“…In one study, smoking increased the rate of developing PSP by 22-fold in males [ 21 ]. Previous findings in Saudi Arabia revealed that 62% of PSP patients were smokers [ 12 ], but to the contrary, another study reported that smoking was documented in only 16% of patients [ 22 ]. It is worth noting that these two studies used a small number of sample patients.…”