Clinical Manifestations of Primary Spontaneous Pneumothorax in Pediatric Patients: An Analysis of 78 Patients

• Main Authors: Chung-Hsein Shih, Hsiu-Wen Yu, Ya-Chun Tseng, Yu-Ting Chang, Chin-Ming Liu, Jen-Wen Hsu
• Format: Article
• Language: English
• Published: Elsevier 2011-06-01
• Series: Pediatrics and Neonatology
• Subjects: pediatric; primary spontaneous pneumothorax (PSP)
• Online Access: http://www.sciencedirect.com/science/article/pii/S1875957211000374

The aims of this investigation were to explore primary spontaneous pneumothorax (PSP) in pediatric patients and to evaluate the clinical manifestations and outcomes of the PSP. Methods: Seventy-eight patients diagnosed with PSP between January 2004 and December 2009 was retrospectively studied. The clinical data on demographics, diagnostic imaging, therapeutic approach, and outcomes were collected and analyzed. Results: The sex ratio of 78 PSP patients was 7.7:1 (male:female=69:9), and the age distribution concentrated between 15 years and 18 years (66 patients, 84.6%). The most common presenting symptom was chest pain (69 patients, 88.5%). The average body mass index was 18.2±1.6 (n=66). Autumn was the more likely attack season for PSP in this study (p=0.005). Twenty-eight patients (35.9%) had tension pneumothorax. Only nine (11.5%) patients had a past history of cigarette smoking. All 21 outpatients received supportive treatment. Out of 57 inpatients, 10 (17.5%) received oxygen therapy, 39 (68.4%) received closed-tube drainage, and 6 (10.5%) received video-assisted thoracoscopic surgery. Apical bleb and subpleural bullae formation were common pathological findings (21 patients, 91.3%). Twenty-four (42.1%) patients experienced a second attack, and six (10.5%) patients had a third attack. Conclusion: Pediatric PSP occurred mainly in boys of the late teenage group with lower body mass index. Autumn was the most likely attack season. There was only a small portion of the patients who smoked. There was no evidence to find a correlation between smoking and pediatric PSP attacks. Length of stay was shorter in supportive treatment and closed-tube drainage patients than that in video-assisted thoracoscopic surgery–treated patients. The outcomes were satisfactory.