Spontaneous Pneumothorax

¹ The Surgical Service, Veterans' Administration Center, Los Angeles, Calif.

Eighty-four cases of spontaneous pneumothorax have been reviewed. In most instances, the cause is unknown, but when it is known, it is usually due to a ruptured bullus or emphysematous bleb. Spontaneous pneumothorax usually occurs during normal activities. The principal symptoms are pain and dyspnea. Symptoms are always present, so every case should be diagnosed. If untreated, spontaneous pneumothorax can be fatal, and the cause of death is usually tension-pneumothorax. If no treatment is administered other than bed rest, the time required for full expansion averages 34 days. If the chest catheter plus water-sealed drainage is used, the average time for re-expansion is three days. For this reason, it is recommended that all cases of spontaneous pneumothorax who have 50 per cent or more collapse of the lung should be treated by catheter, water-sealed drainage. A simple technique for establishing catheter, water-sealed drainage has been described.

Acknowledgment is given to the White Memorial and Los Angeles County Harbor General Hospitals for permission to include patients in our study.