A Study of the Pathogenesis and Management of Spontaneous Pneumothorax

¹ Associate Surgeon, The Children's Hospital Medical Center, Boston
² Chief, Thoracic Surgery Section, V. A. Hospital
³ Assistant in Surgery, Vanderbilt Clinic, Columbia-Presbyterian Medical Center
⁴ Chest Service, Bellevue Hospital and The Presbyterian Hospital; and Department of Surgery, College of Physicians and Surgeons, Columbia University

1. An analysis of 247 cases of spontaneous pneumothorax was undertaken in an effort to evaluate etiology, pathogenesis, and methods of management.

2. Forty-eight patients (19.5 per cent) were found to have active pulmonary tuberculosis and were excluded from further study.

3. The etiology of the pneumothorax in 199 patients was considered to be as follows:

No lung disease evident, 110, bleb formation present, 37, bullous or obstructive emphysema, 45, and pulmonary inflammation or neoplasma, 7 patients.

4. Particular emphasis is placed on the role of the underlying pathology in determining the treatment of choice.

5. Cardiopulmonary disease (emphysema, pulmonary fibrosis, and cor pulmonale) complicating pneumothorax were the major factors contributing to the 11 deaths (5.5 per cent) in this series.