Pneumothorax in Young Adult Males

Spontaneous Pneumothorax in the Royal Navy

“…The presence of respiratory tract infection at the time of onset of the spontaneous pneumothorax.- Leach (1945) found that 18 (14%) of his patients had an upper respiratory infection and 13 had a cough but in only one did the pneumothorax occur during a bout of coughing. In this series there was a history of such an infection in 18 cases (11 %) but the month of admission to hospital does not suggest that this condition is more likely to occur when these infections are most common (Table V).…”

“…Degree of collapse of lung.-Estimates of the degree of collapse vary with the observer and radiological technique and therefore both Leach (1945) and Rottenberg and Golden (1949) divided their cases into only two groups, less than or more than 50% collapse; minimal collapse may not be detected unless radiographs are taken in full expiration and the technique is superlative. In this series the pneumothorax was reported as partial in 97 (59-5%) and complete in 65 (39*9 %), while in 1 it was bilateral and partial (Table VIII).…”

“…Time for expansion of the collapsed lung.- Leach (1945) found that those with less than 50% collapse took about nineteen days to expand while the remainder took about forty-eight days and Cohen and Kinsman (1946) reported an average stay of their Service patients in hospital of forty-one days; in civil practice Schneider and Reissman (1945) observed that their patients were away from work for three to four months and even longer in compensation cases. In this series records are available for 136 patients, the average time for expansion being 39*75 days but there were 8 (4 9%) patients in whom expansion was delayed for 104-171 days.…”

“…Final disposal on recovery from the spontaneous pneumothorax.-148 (90-8 %) patients returned to full duty while 15 (9 2%) were invalided from the Royal Navy as a direct or indirect result of their spontaneous pneumothorax, the invaliding diagnoses being: inactive pulmonary tuberculosis (4), emphysema (4), recurrent pneumothorax (2), asthma (2), multiple bulle (1), effort syndrome (1), following pleurodesis (1). In the U.S. Army Air Force Leach (1945) found that 74% returned to duty, 10% were invalided, and the disposal was unknown in the remaining 16% while Cohen and Kinsman (1946) stated that 80% of their men in the U.S. Army were retained and 7 % invalided.…”

“…Symptoms.-87 (75 %) of the patients traced were symptom-free while 29 (25 %) attributed their breathlessness on exertion (in 27) or winter bronchitis (in 2) to their spontaneous pneumothorax (Table XIV). FOLLOW-UP Year 1943194419451946194719491950195119521953 Chest radiographs.-81 (69 8 %) patients had had a normal chest radiograph within the previous two years while 22 (19%) had had no further chest film following recovery from their pneumothorax. 13 (11 2%) patients had abnormal chest X-rays but in 10 (8-6%) the abnormality was known to have been present following expansion of the collapsed lung, leaving 3 (2-6%) who had developed lung lesions during the follow-up period.…”