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Primary spontaneous pneumothorax in adults

Richard W Light, MD
Section Editor
V Courtney Broaddus, MD
Deputy Editor
Geraldine Finlay, MD


A primary spontaneous pneumothorax (PSP) is a pneumothorax that occurs without a precipitating event in a person who does not have known lung disease. In actuality, most individuals with PSP have unrecognized lung disease, with the pneumothorax resulting from rupture of a subpleural bleb [1-5].

In this topic review, the incidence, pathogenesis, presentation, and management of PSP are discussed. Secondary spontaneous pneumothorax, which occurs as a complication of underlying lung disease, is reviewed in detail elsewhere. (See "Secondary spontaneous pneumothorax in adults".)


The incidence of primary spontaneous pneumothorax (PSP) in men varies geographically, from 7.4 per 100,000 population per year in the United States to 37 per 100,000 population per year in the United Kingdom. The incidence is substantially less in women than in men, ranging from 1.2 per 100,000 population per year in the United States to 15.4 per 100,000 population per year in the United Kingdom [6]. The reason for these differences is unknown.

Estimates of the incidence of recurrent PSP range from 25 percent to more than 50 percent, with most recurrences seen within the first year [6]. As an example, a study of 153 patients with PSP found a recurrence rate of 54 percent [7]. Female gender, tall stature in men, low body weight, and failure to stop smoking have been associated with an increased risk of recurrence [7,8].


Factors that have been proposed or shown to predispose patients to primary spontaneous pneumothorax (PSP) include smoking, family history, Marfan syndrome, homocystinuria, and thoracic endometriosis.

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Literature review current through: Nov 2017. | This topic last updated: Nov 27, 2017.
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