Abstract

Background: Pneumothorax is defined as a presence of air in the pleural space. Pneumothorax classified in to spontaneous and nonspontaneous pneumothorax based on presence of precipating factor or any cause. Base on underlying pulmonary disease Spontaneous pneumothorax then further classified into primary spontaneous pneumothorax (PSP) and secondary spontaneous pneumothorax. A rupture of small subpleural blebs or bullae were commonly being the culprit of PSP. Case Presentation : A 34 year old female patient came to emergency clinic with a chief complaint of three day history of acute worsening shortness of breath. The shortness of breath is accompanied by cough, chest tightness, and chest pain or pleuritic exertional chest pain. Based on patient history and other laboratory finding, patient were then assesed with PSP, chest tube was then performed on this patient. On seventh day of admission the re-expansion of the lung was documented on chest x-ray and patient got discharge afterward. Following fifth days of dischared, patient came back with the same symptom, and chest x-ray revealed sign of pneumothorax. A Computed Tomography performed in this patient revealed left lung bullae. Patient then referred to thoraxic surgeon. Conclusion: PSP is an urgent clinical condition that need proper and imidiate management. Management consist of allowing re-expansion of the lung and prevent the reccurence. Combining pleurodesis and bullectomy or blebectomy by surgical stapler by Video assisted Thoracoscopy surgery (VATS) or open approaches is consider the most effective treament in preventing recurrence of PSP.

Key words: Keyword: Primary Spontaneous Pneumothorax, Bullae, Pleurodesis and Bullectomy.