A Clinical Study about Symptomatic Spontaneous Pneumothorax

Park, Sung Won; Yun, Byung Ho; Kim, Kyung Ah; Ko, Sun Young; Lee, Yeon Kyung; Shin, Son Moon

Abstract

OBJECTIVE
Spontaneous pneumothorax is more common during the newborn period than at any other time in childhood. We intended to analyze the incidence, clinical course and the result of treatment of symptomatic spontaneous pneumothorax by distinguishing primary and secondary pneumothorax.
METHODS
Infants who were born at Cheil General Hospital from January 1, 2002 to May 31, 2005 having respiratory difficulty, being shown pneumothorax in the chest X-ray were enrolled. Pneumothorax was divided into two groups:primary pneumothorax, not having preceding disease; secondary pneumothoax, having preceding and accompanied pulmonary disease.
RESULTS
169 out of 31,156 infants had symptomatic pneumothorax, which was 0.54%. The average gestational age was 38.+/- (25.5~42.2) weeks and the average birth weight was 3130+/-1041 g (925~4225) g. Premature infants were 12 (7.1%) and full?term infants were 157 (92.9%). It occurred more frequently to male (male:female=1.32:1) and Rt. side (Rt 63.9%; Both 32%; Lt 4.1%) and most of them occurred within 12hrs after birth. Primary pneumothorax was seen in 150 (88.8%) cases and secondary ones was seen in 19 cases (11.2%). Preceding pulmonary disease included respiratory distress syndrome, neonatal pneumonia, meconium aspiration syndrome, persistent pulmonary hypertension and pulmonary hypoplasia. All infants received oxygen therapy and 2 of them had chest tube insertion, which were secondary pneumothorax. There were no significant accompanied intracranial hemorrhage or urinary tract abnormalities.
CONCLUSION
In this study, the incidence of symptomatic pneumothoax was 0.54%. Most of them occurred in 12hrs after the birth. They did not accompany other anomalies. Primary pneumothorax showed good prognosis by conservative therapy.