SPONTANEOUS PNEUMOTHORAX AFTER FLIGHT

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A 42-year-old patient with a history of extrauterine pregnancy and interadnexal hysterectomy for persistent cervical HPV infection was referred to the Thoracic Surgery Clinic for increased shortness of breath. The patient was diagnosed with a spontaneous pneumothorax following a flight. She underwent pleural drainage at another hospital and was transferred for specialist surgical management. A CT scan was performed and showed a pneumothorax and collapsed lung. Video-assisted thoracic surgery (VATS) thoracoscopy was performed with evidence of apical emphysema bullae, which were resected. As this was the first episode of spontaneous pneumothorax and considering the young age of the patient, no pleurodesis was performed. The patient was discharged five days after surgery after suppression of pleural drainage.

Primary spontaneous pneumothorax is usually caused by the rupture of subpleural blebs or bullae. In the first episode of spontaneous pneumothorax, pleurodesis is not performed except in well-selected cases - single lung, professions with a risk of pneumothorax recurrence [pilot/diver]. However, in the presence of a persistent air leak on the chest tube, the decision for chemical pleurodesis should be considered.

Fig. 1- CT scan performed upon admission showed a partially collapsed lung and right pneumothorax.

Fig. 2- Intraoperative aspect of apical blebs.