Spontaneous Pneumothorax: A Review of 71 Cases

¹ Chief of Surgery, Veterans Administration Hospital.
² Consultant to Veterans Administration Hospital.

1. Seventy-one instances of spontaneous pneumothorax have been reviewed, not all of which were the simple or idiopathic type.

2. Nineteen (28 per cent) had prior pneumothorax.

3. Of 19 treated with bed rest alone, there were two failures and four known recurrences. The average hospital stay was 22 days.

4. Of 39 treated with intercostal catheter suction, the average hospital stay was 12.5 days. There were four failures and four recurrences.

5. There was no significant complication associated with treatment by intercostal catheter suction.

6. Thoracoscopy was done in 29 and positive findings were recorded in 16. We believe thoracoscopy in addition to x-ray an important aid in determining whether to recommend open thoracotomy or an initial trial with catheter suction.

7. With an initial spontaneous pneumothorax of less than 20 per cent, in the absence of demonstrable large peripheral blebs, bed rest may be the treatment of choice. When it exceeds 20 per cent and initial open thoracotomy does not seem justifiable, intercostal catheter suction therapy, as described, has proven to be a safe and effective method of treatment in a high percentage of our cases.