Is There a Role for Chest Computed Tomography in Patients with Primary Spontaneous Pneumothorax?

Background: Primary spontaneous pneumothorax is a relatively common condition in young adults. Although blebs and bullae are frequently found in patients with primary spontaneous pneumothorax, they are very rarely the actual cause of the pneumothorax. Objective: To assess our experience with chest computed tomography evaluation in patients with recurrent spontaneous pneumothorax as compared to their histopathology findings. Study Design: A prospective study analysis. Materials and Methods: From January 2013 to December 2016, 38 consecutive patients with unilateral recurrent spontaneous pneumothorax underwent video-assisted thoracic surgery. Their chest computed tomography scans were reviewed and compared with their histopathology findings. Results: Thirty-six adult patients with unilateral recurrent spontaneous pneumothorax were included; their mean age was 33.9 years, and they all received video-assisted thoracic surgery and mechanical pleurodesis. Blebs or bullae were present in the chest computed tomography scans of fourteen patients (39%); of those fourteen patients, five (35.7%) had emphysematous changes in histopathology. Seventeen out of the thirty-six (47%) had no blebs or bullae in their chest computed tomography scans; of those seventeen patients, ten (59%) had emphysema like changes and seven (41%) had blebs in their histopathology studies. The remaining five patients (14%) had normal chest computed tomography scans. Conclusions: We conclude that preoperative chest computed tomography is not beneficial in every patient with recurrence of primary spontaneous pneumothorax.