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[Simultaneous bilateral spontaneous pneumothoraces].

H Minami1, K Senda, Y Horio

  • 1Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital.

Nihon Kyobu Shikkan Gakkai Zasshi
|October 1, 1990
PubMed
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Simultaneous bilateral pneumothoraces are rare but often linked to underlying lung diseases, especially lung cancer. Treatment varies by patient age and condition, with surgery recommended for younger individuals without disease.

Area of Science:

  • Pulmonology
  • Thoracic Surgery
  • Oncology

Background:

  • Spontaneous pneumothorax can occur bilaterally, a rare but serious condition.
  • Understanding the underlying causes and optimal management of bilateral pneumothorax is crucial.

Observation:

  • A retrospective study identified 7 cases (1.9%) of simultaneous bilateral pneumothoraces in 377 patients with spontaneous pneumothorax.
  • Patients often presented with severe dyspnea, similar to unilateral cases.
  • Underlying pulmonary disease was present in most patients, with lung cancer being a significant factor.

Findings:

  • Two cases of lung cancer and one of metastatic lung disease experienced bilateral pneumothoraces.
  • The incidence of bilateral pneumothorax in lung cancer patients with pneumothorax was notably high.

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  • Malignant cases treated with tube drainage resulted in respiratory failure and death.
  • Two elderly patients with small bilateral pneumothoraces recovered with conservative management (bed rest).
  • Two younger patients without underlying disease were treated with tube drainage followed by surgery.

    • Implications:

    • Simultaneous bilateral spontaneous pneumothoraces frequently indicate underlying pulmonary pathology, particularly lung cancer.
    • Younger patients without underlying disease may benefit from surgical intervention after initial symptom management.
    • Elderly patients and those with malignancy require individualized and cautious treatment strategies.