PNEUMOTHORAX   

The existence of air in the pleural cavity between the two leaflets of the pleura is called pneumothorax. The most frequent type of pneumothorax is the spontaneous or idiopathic pneumothorax which develops after the rupture of a sub-pleural blebs or pulmonary air cysts.
Spontaneous pneumothorax occurs usually in young, tall and thin people, who have the characteristics of Marfan syndrome and it is more frequent in men.
The treatment of this situation depends on the size of the pneumothorax, the symptoms and the respiratory function. The treatment of the symptomatic pneumothorax, (even the small one) or any pneumothorax larger than 25% consists of chest tube insertion, connected to a plastic chamber and the tube is submerged into water seal. This procedure is very simple, safe, and effective and is performed under local anesthesia. In case of recurrence or when the air leaquage continues for a period more than 4-6 days or when the lung is not completely expanded, a more radical surgical treatment is recommended. The problem is treated thoracoscopically or by means of a very limited thoracotomy. Thoracoscopy technique is associated with four folds possibility of recurrence compared with the limited thoracotomy. Also our decision regarding the type of treatment is affected by the patient’s occupation. Patients who are pilots, navy employees, divers or mountaineers are recommended to be treated surgically even if they have the first episode of pneumothorax. It must be mentioned that there are other kinds of pneumothorax such as the iatrogenic, the post-traumatic and the post- surgical pneumothorax.