Chest
Computed Tomography in the Etiologic Assessment of Idiopathic Spontaneous Pneumothorax
Section snippets
MATERIAL AND METHODS
Twenty patients with ISP were studied two months after the pneumothorax episode. The procedure included clinical examination, chest roentgenogram, serum α1-antitrypsin dosage8 with phenotype electrophoretic determination,9 pulmonary function tests, and CT scan. They were selected from a series of pneumothoraces according to the following criteria: age below 45 years; no respiratory history; normal chest roentgenogram (posteroanterior and lateral films) assessed by three independent readers; and
Clinical Data
Idiopathic spontaneous pneumothorax occurred on the left side in 11 patients and on the right side in nine. Ten patients had recurrent ISP (ipsilateral in eight). Recent effort was the possible cause of the pneumothorax in five patients; ISP occurred at rest in the others. Weight and height were within the standards of the Metropolitan Life Insurance Company19 for the two groups. Nevertheless, the mean weight was significantly lower in the ISP group than in the control group: 65.3 ± 8.2 kg vs
DISCUSSION
Idiopathic spontaneous pneumothorax occurs most often in young adults,20, 21, 22 predominantly in tall men.2, 23, 24 Many authors hypothesize that tall lungs play a part in the genesis of bullae, implicating an increase in the pulmonary distension pressure.25, 26 Peters et al24 and Kawakami et al27 noted that the lung height was greater in their ISP patients than in their controls. In the present study, the clinical observations fit well with the literature data. However, the patients’ mean
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