Spontaneous pneumothorax in children: a radiological perspective
Ozlem Ozkale Yavuz1,2, Ercan Ayaz3,4, H Nursun Ozcan3
1Division of Pediatric Radiology, Department of Radiology, Hacettepe University School of Medicine, Sihhiye, 06230, Ankara, Turkey. drozlemozkale@hotmail.com.
Insights
Spontaneous pneumothorax in children is often linked to underlying lung conditions. Radiologists should identify subpleural air cysts and consider underlying diseases in bilateral cases or younger patients to guide treatment and reduce recurrence.
Area of Science:
- Pediatric Radiology
- Pulmonology
Background:
- Spontaneous pneumothorax is a common condition with diverse causes.
- Accurate radiological assessment is crucial for effective management and avoiding repeat imaging.
Purpose of the Study:
- To radiologically characterize the etiologic factors of spontaneous pneumothorax in pediatric patients.
- To correlate imaging findings with underlying causes and patient demographics.
Main Methods:
- Retrospective review of 39 children diagnosed with spontaneous pneumothorax.
- Evaluation of demographic data, presence of underlying lung disease, and imaging findings (including chest computed tomography).
Main Results:
- Primary spontaneous pneumothorax (PSP) was diagnosed in 21 children, with 38.9% showing subpleural air cysts.
- Secondary spontaneous pneumothorax (SSP) in 18 children was most commonly associated with respiratory (33.3%), infectious (33.3%), and interstitial lung diseases (27.7%).
- Children with SSP were younger than those with PSP, and recurrence rates were higher in PSP (52.3%) than SSP (16.6%). Bilateral pneumothorax was noted in three SSP cases.
Conclusions:
- Identifying etiologic factors of pediatric spontaneous pneumothorax aids in recurrence risk reduction.
- Radiologists should assess for subpleural air cysts and suspect underlying disease in bilateral pneumothorax or younger patients.
Background:
Spontaneous pneumothorax is a common clinical condition due to several etiologies. Appropriate radiologic assessment helps avoid re-imaging and guide individualized management.
Objective:
To describe the etiologic factors of spontaneous pneumothorax in children from a radiological perspective.
Materials And Methods:
Thirty-nine children with spontaneous pneumothorax were evaluated according to their demographic characteristics, the presence of underlying lung diseases, and imaging findings.
Results:
Twenty-one patients without underlying lung disease were assessed as primary spontaneous pneumothorax; eight of these 21 patients (38.9%) had subpleural air cysts in the apices/upper lobes of the lung on chest computed tomography (CT). In the remaining 18 patients with secondary spontaneous pneumothorax, the most common causes were respiratory diseases (33.3%), infectious lung diseases (33.3%), interstitial lung diseases (27.7%), and connective tissue diseases (5.5%). The mean age of children with secondary spontaneous pneumothorax was lower than that of children with primary spontaneous pneumothorax (P = 0.002). Recurrences occurred in 11 patients (52.3%) with primary spontaneous pneumothorax and three patients (16.6%) with secondary spontaneous pneumothorax. Bilateral pneumothorax was observed in three of the 18 patients with secondary spontaneous pneumothorax.
Conclusion:
Identifying the etiologic factors of spontaneous pneumothorax may help clinicians plan how to reduce the risk of recurrence. Radiologists should keep in mind the possible underlying diseases and assess imaging methods in children with spontaneous pneumothorax for subpleural air cysts and be suspicious about an underlying disease in cases of bilateral pneumothorax and in younger patients.
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