Beware of Simultaneous Bilateral Spontaneous Pneumothorax: Case Reports and Literature Review

INTRODUCTION: SBSP (Simultaneous Bilateral Spontaneous Pneumothorax) means concurrent or coincident bilateral pneumothorax. Usually, chest drains insertion is followed by pleurodesis to prevent recurrence. METHOD: There are a few cases of SBSP each year in Wong Tai Sin Hospital of Hong Kong. It consists of two groups clinically. One group is easily tackled by bilateral chest drain insertion followed by pleurodesis and the other group is difficult to achieve full lung expansion despite the application of negative suction via the chest drains. Pleurodesis cannot be achieved in the latter as the visceral and parietal pleura are not in touched. RESULTS: By considering the pressure difference between the different intrapulmonary compartments, the underlying cause can be identified. The following two cases demonstrated the basic principle—the success of chest drain relies on an enclosed pleural space. DISCUSSION AND CONCLUSION: Literature review of the SBSP will be followed by the proposed treatment.