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Spontaneous pneumothorax: a single-institution, 12-year experience in patients under 16 years of age
D T Wilcox1, P L Glick, H L Karamanoukian
1Department of Surgery, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, USA.
Objective:
To characterize the natural history and outcome of spontaneous pneumothorax in patients under age 16 years.
Design:
This is a retrospective review in which all patients admitted to the authors' institution (between December 1980 and July 1993) with a diagnosis of spontaneous pneumothorax were included. Information was obtained from the hospital records.
Setting:
This study was performed in a university childrens' hospital.
Patients:
All patients under 16 years with a diagnosis of spontaneous pneumothorax were included.
Results:
Seventeen patients were admitted and analyzed. Only three admissions were for recurrence. The main symptoms included chest pain (100%), shortness of breath (41%), and cough (6%). Chest tube drainage was successful in 65% of the cases; the median time was 4 days. Two patients had a persistent air leak. An underlying cause was recognized in 42% of cases. Seven operations were necessary, and the mean follow-up periods is 31 months, with no recurrence reported to date.
Conclusion:
Spontaneous pneumothorax occurs in the pediatric population, although it is less common in adults. An underlying pathology is more frequently observed in pediatric patients, but recurrence is less common. Chest tube drainage alone is sufficient treatment for the majority of patients; however, a significant number require some form of surgical intervention.