title: Use of endobronchial one-way valves reveals questions on etiology of spontaneous pneumothorax: report of three cases.
abstract: Spontaneous pneumothoraces are believed to arise when air from the supplying airway exit via a ruptured visceral pleural bleb into the pleural cavity. Endobronchial one-way valves (EBVs) allow air exit (but not entry) from individual segmental airways. Systematic deployment of EBVs was applied to three patients with secondary spontaneous pneumothoraces and persistent airleak. In all cases, balloon-catheter occlusion of the upper lobe bronchus stopped the airleak. EBVs applied to individual upper lobe segmental airways failed to terminate the airleak, which only stopped after placements of multiple EBVs to occlude all upper lobe segments. The observation questions the traditional belief of 'one-airway-one-bleb-one-leak' in spontaneous pneumothorax.
authors.affiliation: Department of Medicine & Geriatrics, Princess Margaret Hospital, Hong Kong. yuwc@ha.org.hk
authors.forename: Wai Cho
authors.initials: WC
authors.lastname: Yu
authors.forename: Yiu Cheong
authors.initials: YC
authors.lastname: Yeung
authors.forename: Yiu
authors.initials: Y
authors.lastname: Chang
authors.forename: Yuet Ling
authors.initials: YL
authors.lastname: Tsang
authors.forename: Kwok Chu
authors.initials: KC
authors.lastname: Kwong
authors.forename: Hau Chung
authors.initials: HC
authors.lastname: Kwok
authors.forename: Y C Gary
authors.initials: YC
authors.lastname: Lee
mesh_terms: D000368:Aged; D001768:Blister / Q000150:complications*; D001999:Bronchoscopy; D002406:Catheterization, Peripheral / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000150:complications; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D011859:Radiography; D016896:Treatment Outcome