Are Adolescents With Chest Wall Deformity Potential Primary Spontaneous Pneumothorax Patients?

Introduction: Chest wall deformities often become apparent with growth spurts during adolescence. Alterations in the structure of the chest wall can result in the development of pulmonary bullae and blebs, which may lead to spontaneous pneumothorax. There are limited data on this subject in the literature. In this study, it is aimed to investigate the presence of bullae and bleb in patients with anterior and posterior chest wall deformities.

Methods: Computed tomography scans of adolescent idiopathic scoliosis, pectus carinatum, and pectus excavatum patients were analyzed. The presence of bullae and/or bleb (BB) was recorded as "present" or "absent."

Results: One hundred fifty patients with chest wall deformity have been included in the study. BB has been detected in 55 (36.7%) of the patients. Surgical procedures were performed in 45 (30%) of the patients due to chest wall deformity. BB was present in 12 (26.7%) of these patients. A statistically significant difference has been found between the presence of complications and the presence of BB in surgical patients (P < 0.001). In patients who developed complications, there was a statistically significant difference between the presence of BB and the duration of chest tube follow-up (P = 0.031), as well as between the presence of BB and the length of hospitalization (P = 0.006).

Conclusions: A significant proportion (36.7%) of patients with chest wall deformity had BB. Chest wall deformities and primary spontaneous pneumothorax (PSP) may have common etiologic factors. It should be kept in mind that patients with chest wall deformities may be potential PSP patients. Medical counseling about PSP should be considered for these patients.