Treatment of idiopathic spontaneous pneumothorax.

Abstract

During the past four years the majority of idiopathic spontaneous pneumothorax patients admitted to the thoracic surgery section of the Veterans Administration Hospital (Kennedy) have been treated by simple operative procedures with highly satisfactory results. Our objective has been to induce rapid reexpansion of the lung by aspiration, water seal tube and open thoracotomy as the indications became clear from study of each case. Kjaergaard 1 in 1932 was among the first to note the lack of relationship between pulmonary tuberculosis and spontaneous pneumothorax in healthy persons. This concept has been confirmed by the observations of Ornstein and Lercher 2 and others. Spontaneous rupture of subpleural vesicles is the commonest cause of idiopathic pneumothorax, as it is in some spontaneous pneumothoraces complicating pulmonary tuberculosis (Perry 3 ). The mechanism responsible for the rupture is increased pressure in the vesicle due to an improper function of the bronchus leading to the vesicle.