Diagnosis and treatment of primary spontaneous pneumothorax

Abstract

Primary spontaneous pneumothorax (PSP) commonly occurs in tall, thin, adolescent men. Though the pathogenesis of PSP has been gradually uncovered, there is still a lack of consensus in the diagnostic approach and treatment strategies for this disorder. Herein, the literature is reviewed concerning mechanisms and personal clinical experience with PSP. The chest computed tomography (CT) has been more commonly used than before to help understand the pathogenesis of PSP and plan further management strategies. The development of video-assisted thoracoscopic surgery (VATS) has changed the profiles of management strategies of PSP due to its minimal invasiveness and high effectiveness for patients with these diseases.

Primary spontaneous pneumothorax in a recreational athlete

“…Spontaneous pneumothorax can further be subdivided into two groups: primary spontaneous pneumothorax (PSP), where there is no history of underlying lung pathology; and secondary spontaneous pneumothorax (SSP), where there is pre-existing lung pathology. [1][2][3] PSP is more common in males, with an incidence of 7.4 -18 cases/100 000/year in males, and 1.2 -6 cases/100 000/year in females. [2,3] Other risk factors include smoking and being a tall, thin male between the ages of 10 and 30 years.…”

“…[1][2][3] PSP is more common in males, with an incidence of 7.4 -18 cases/100 000/year in males, and 1.2 -6 cases/100 000/year in females. [2,3] Other risk factors include smoking and being a tall, thin male between the ages of 10 and 30 years. [3] Almost 10% of cases have a positive family history of PSP, which is linked to a speci c gene mutation, folliculin, associated with a rare disease called Birt-HoggDubé syndrome.…”

“…[2,3] Other risk factors include smoking and being a tall, thin male between the ages of 10 and 30 years. [3] Almost 10% of cases have a positive family history of PSP, which is linked to a speci c gene mutation, folliculin, associated with a rare disease called Birt-HoggDubé syndrome. [3] Changes in climate, with decreased atmospheric pressures and colder temperatures, have been identi ed as possible contributing factors in PSP.…”

“…[1] This can occur spontaneously or subsequent to direct trauma to the chest wall. Primary spontaneous pneumothorax (PSP) occurs in the absence of any underlying lung pathology, [1][2][3] and although it is a well-recognised and well-described cause of acuteonset chest pain, the prevalence of this condition in the athletic community is uncommon. is may be owing to the low incidence of this condition in athletes, underreporting of cases and possibly missed diagnoses.…”

Bilateral Tension Pneumothoraces Leading to Cardiac Arrest after Coronary Artery Bypass Surgery

“…However, large or tension pneumothoraces may pose a danger to patients cardiorespiratory function which should be timely identified and be treated as an emergency. 5 In lieu of a well-defined disease state, there is probably a subset of robust patients whose symptoms progress much more slowly due to their ability to compensate through other mechanisms. In this subclass of patients, the classic symptoms may be absent or are developing much more slowly, leaving only none-specific findings such as pain, dyspnea, and tachypnea.…”