Clinical Analysis for Patients with Spontaneous Pneumothorax

Clinical analysis for 95 cases with spontaneous pneumothorax which were treated at the Department of Thoracic and Cardiovascular Surgery of Ewha Womans University Hospital from March, 1982 to February, 1988 had been done. Among 95 cases male was 81 and female was 14. Male to female ratio was 5.8:1. The youngest patient was 16 years old and the oldest was 73 years old. Most of the patients were between 21 and 40 years old. Ninety cases had unilateral pneumothorax and 5 cases had bilateral pneumothorax. Sudden dyspnea was appeared in 85.3% of all cases and chest pain was in 60% of patients. Initial treatment was bed rest with high oxygen therapy for 6 patients. Tube thoracostomy was done for the remaining cases. The results of initial treatment in 90 paients with unilateral pneumothorax as follow; Thoracotomy was done for 11 cases due to persistent air leak through the chest tube. initial treatment was sucessful in 79 cases but 22 cases were recurred. So recurrence rate was 27.8%. Among 22 cases, 13 cases were operated. There was no recurrence in thoracotomy cases. In 5 patients with bilateral pneumothorax, two cases were operated on one side. Bilateral thoracotomy was done for one patient.

The underlying causes of the spontaneous pneumothorax were bullae in 16 cases, bullae with pulmonary tuberculosis in 9 cases and pulmonary tuberculosis in 3 cases among 28 operations of 27 cases. Among 68 of non-thoracotomy patients, no definite causes were found in 31 cases and obstructive lung disease in 2 cases, lung cancer, lung abscess and pneumonia in 1 case each.