Spontaneous pneumothorax

Spontaneous pneumothorax is usually a benign disorder caused by rupture of subpleural blebs. Treatment should provide for rapid rehabilitation. Because of a 70 to 80 per cent recurrence rate after a second or third episode, pleural abrasion should be performed to prevent further attacks. Persistent air leak, large apical blebs, initial pneumothorax in flight personnel, and the rare tension or hemopneumothorax are additional indications for an immediate pleura-obliterating procedure. The method of treatment for the initial episode in patients without the foregoing indications for operation should be geared toward safe, early, complete rehabilitation to avoid the potential danger and obvious economic hardships of conservative therapy. Simple transaxillary thoracotomy has the advantages of taking less time and causing less discomfort and minimal scarring.