CASE HISTORY – May 2013

Simultaneous bilateral primary spontaneous pneumothorax

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Abstract

The current case report describes a 24-year old male patient with simultaneous bilateral primary spontaneous pneumothorax. He was admitted to a local hospital due to suddenly developing chest pain and progressive dyspnoea. A chest radiograph revealed bilateral subtotal pneumothorax. Before the study results became available the patient collapsed and developed cardiac arrest. His condition stabilised after immediate bilateral chest tube drainage, tracheal intubation and initiation of mechanical ventilation. Chest computed tomography demonstrated multiple bullae in both upper lobes.

The patient was admitted to Tartu University Hospital for surgical treatment to avoid recurrence of the disease. Bilateral videothoracoscopic resection of the upper lobe bullae and parietal pleurectomy were performed. The operation and the postoperative period were uneventful. During the 8-month follow-up period pneumothorax did not recur.

Simultaneous bi lateral spontaneous pneumothorax is a very rare but potentially life-threatening condition. The diagnosis should be based on clinical examination and immediate bilateral chest tube thoracostomy is mandatory.