Affiliation:
1. Military Medical Academy, Clinic for Thoracic Surgery, Belgrade
Abstract
Introduction. Simultaneous bilateral spontaneous pneumothorax (SBSP) is a
potentially life-threatening state that may imitate many lung diseases. The
aim of this report was to describe the presentation and highlights the
potential difficulties in diagnosis and management of patients with SBSP.
Case outline. A 23-year-old female was urgently assessed because of a
progressive dyspnoea of 2-day's duration with associated bilateral chest
pain. Lung auscultation revealed equally diminished breath sounds on both
sides. During initial examination, there was the evidence of symptomatic
deterioration with bilateral pleuritic chest pain, increased dyspnoea and
agitation. She was found to have type II respiratory failure with the
following biochemical parameters: pH=7.34, PaCO2=6.3 kPa and PaO2=7.9 kPa.
The chest radiograph confirmed bilateral partial pneumothoraces of
approximately 30%. Both left and right-sided thoracostomies with large-bore
chest drain insertions were performed emergently, followed by partial
resolutions of pneumothoraces. CT of the chest demonstrated residual
pneumothoraces bilaterally with multiple apical bullae. In the further
course, she subsequently underwent video-assisted thoracoscopic surgery with
bilateral apicoectomies, bullectomies and pleural abrasion. Her chest drains
were removed 3 days after surgery and a chest radiograph post-treatment
demonstrated resolution of the pneumothoraces. She was discharged home
without complications. Conclusion. Using clinical presentation, diagnostic
algorithm and therapeutic management applied in the case of our patient, we
emphasized a few mandatory steps in establishing the diagnosis of SBSP and
further treatment.
Publisher
National Library of Serbia
Cited by
1 articles.
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