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Medline ® Abstracts for References 1-5

of 'Primary spontaneous pneumothorax in adults'

1
TI
Spontaneous pneumothorax.
AU
Sahn SA, Heffner JE
SO
N Engl J Med. 2000;342(12):868.
 
AD
Division of Pulmonary and Critical Care Medicine, Allergy and Clinical Immunology, Medical University of South Carolina, Charleston 29425, USA. sahnsa@musc.edu
PMID
2
TI
Spontaneous pneumothorax
AU
Gobbel, WG Jr, Rhea, WG Jr, Nelson, IA, Daniel, RA Jr
SO
J Thorac Cardiovasc Surg. 1963; 46:331.
 
AD
3
TI
Computed tomography in the etiologic assessment of idiopathic spontaneous pneumothorax.
AU
Lesur O, Delorme N, Fromaget JM, Bernadac P, Polu JM
SO
Chest. 1990;98(2):341.
 
In an attempt to elucidate the origin of the so-called idiopathic spontaneous pneumothorax (ISP), clinical examination, pulmonary function tests, and computed tomography (CT) with visual quantification and density analysis were performed in 20 young patients two months after an ISP episode. Twenty controls were recruited for CT. The chest roentgenograms were normal in the two groups. The results indicated the presence of various types of emphysematous lesions (EL) in the ISP group located predominantly in the apical fields with subpleural location in 16 patients. Interestingly, diffuse but moderate centrilobular emphysema was noted in 12 of 20 patients. The EL visual quantification was always less than 5 percent of the CT slices' total areas. The lung mean density shifted significantly toward the air density in the patient group (patients: -743 +/- 57.5 HU vs controls -713 +/- 59.5 HU, p less than 0.01). These findings suggest that CT may be useful for early assessment of EL in patients with ISP.
AD
Service des Maladies Respiratoires et Réanimation Respiratoire, CHU de Nancy-Brabois, France.
PMID
4
TI
Nonsmoking, non-alpha 1-antitrypsin deficiency-induced emphysema in nonsmokers with healed spontaneous pneumothorax, identified by computed tomography of the lungs.
AU
Bense L, Lewander R, Eklund G, Hedenstierna G, Wiman LG
SO
Chest. 1993;103(2):433.
 
This case-control study is based on an investigation of 27 nonsmoking patients with radiologically verified spontaneous pneumothorax (SP) and ten healthy never-smoker control subjects. The posteroanterior and lateral radiographs of patients and control subjects were normal. They were all submitted to the same clinical, laboratory, and radiologic examinations, including computed tomography (CT) of the lungs, with the aim of detecting any parenchymatous lung changes. Emphysema-like changes (ELCs) were detected on CT in 22 (81 percent) of the 27 patients, and if the ELC cases detected during interventional surgery are added, the frequency increases to 24/27 (89 percent). In 20 patients with unilateral SP, at least one ELC was found in 13 of the 20 SP-affected lungs, but only in five of the 20 lungs that were not diagnosed as having SP (p<0.05). ELCs were found more frequently in the upper than in the lower lung regions (p<0.05) and more frequently in the radiologically peripheral than in central regions (p<0.001). No ELC was detected in the control group on CT. No alpha 1-antitrypsin deficiency was found in the 27 nonsmoking patients with radiologically verified SP who had ELCs despite the absence of these known promoters of emphysema.
AD
Department of Occupational Medicine, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
PMID
5
TI
Video-assisted thoracic surgery for primary spontaneous hemopneumothorax.
AU
Hwong TM, Ng CS, Lee TW, Wan S, Sihoe AD, Wan IY, Arifi AA, Yim AP
SO
Eur J Cardiothorac Surg. 2004;26(5):893.
 
OBJECTIVE: Video-assisted thoracic surgery (VATS) has changed the way we manage a number of thoracic conditions. This study presents near over a decade of experience from our institution on management of spontaneous hemopneumothorax (SHP), with particular reference to the use of VATS.
METHODS: Retrospective review between March 1988 and December 2002 with 793 patients treated for spontaneous pneumothorax, 30 (3.8%) patients had SHP. The clinical features, indications for surgery and outcomes are discussed.
RESULTS: All 30 SHP patients were male with mean age of 25 years. Signs of significant hypovolemia occurred in 4 patients, 3 required blood transfusion. Mean initial blood drainage from tube thoracostomy was 594 ml. All SHP patients received surgery (5 thoracotomies, 25 VATS). Active bleeding was identified in 16 patients; 12 from torn apical vascular adhesion band and 4 from vascular bleb. Postoperative complications after thoracotomy include 2 chest infections and 1 air leak, while VATS had 1 chest infection and 1 air leak (P=0.022). Mean postoperative hospital stay following VATS was 3.9 days and thoracotomy 7.5 days (P=0.0021). There is no recurrence of pneumothorax or SHP during mean follow-up of 21 months.
CONCLUSION: SHP can be life threatening and is a cause for patients presenting with unexplained signs of significant hypovolemia. Surgery in the form of VATS should be considered early in the management of SHP, with potentially less postoperative complications and shorter postoperative hospital stay compared with open thoracotomy.
AD
Division of Cardiothoracic Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.
PMID