title: A case of simultaneous bilateral spontaneous pneumothorax after the Nuss procedure.
abstract: We present a case of simultaneous bilateral spontaneous pneumothorax caused by a pleuro-pleural communication formed from Nuss procedure for pectus excavatum. A 17-year-old man with a history of Nuss operation complained chest pain and dyspnea. A chest roentgenogram demonstrated a tiny bilateral pneumothorax and two metallic bars inserted at the Nuss procedure. Computed tomography revealed furthermore a bulla in the apex of the left lung. The bilateral pneumothorax critically deteriorated after 4 days from onset and urgent bilateral chest drainages were performed. Nevertheless the drainages the full expansion of both lungs was not obtained and air leakage only from left side was continued. A video-assisted left bullectomy was performed 9 days after the tube insertion. The two bars penetrating anterior mediastinal pleura were thought to be a cause of the simultaneous bilateral spontaneous pneumothorax.
authors.affiliation: Department of Thoracic Surgery, Kofu Municipal Hospital, 366 Masutsubo, Kofu, Yamanashi, Japan.
authors.forename: Shunichiro
authors.initials: S
authors.lastname: Matsuoka
authors.affiliation: Department of Thoracic Surgery, Kofu Municipal Hospital, 366 Masutsubo, Kofu, Yamanashi, Japan. miyazawa@kmh.kofu.yamanashi.jp.
authors.forename: Masahisa
authors.initials: M
authors.lastname: Miyazawa
authors.affiliation: Department of Thoracic Surgery, Kofu Municipal Hospital, 366 Masutsubo, Kofu, Yamanashi, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kashimoto
authors.affiliation: Department of Thoracic Surgery, Kofu Municipal Hospital, 366 Masutsubo, Kofu, Yamanashi, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kobayashi
authors.affiliation: Department of Thoracic Surgery, Kofu Municipal Hospital, 366 Masutsubo, Kofu, Yamanashi, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Mitsui
authors.affiliation: Department of Thoracic Surgery, Kofu Municipal Hospital, 366 Masutsubo, Kofu, Yamanashi, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Tsunoda
authors.affiliation: Department of Thoracic Surgery, Kofu Municipal Hospital, 366 Masutsubo, Kofu, Yamanashi, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kunitomo
authors.affiliation: Department of Thoracic Surgery, Kofu Municipal Hospital, 366 Masutsubo, Kofu, Yamanashi, Japan.
authors.forename: Hisanao
authors.initials: H
authors.lastname: Chisuwa
authors.affiliation: Department of Thoracic Surgery, Kofu Municipal Hospital, 366 Masutsubo, Kofu, Yamanashi, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Haba
mesh_terms: D000293:Adolescent; D015505:Chest Tubes / Q000009:adverse effects; D004417:Dyspnea / Q000209:etiology; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D008297:Male; D010994:Pleura; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery; D013902:Radiography, Thoracic; D012086:Reoperation; D016156:Respiratory Tract Fistula / Q000209:etiology; D012422:Rupture, Spontaneous / Q000209:etiology; D013525:Surgical Instruments / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Nuss procedure; Simultaneous bilateral pneumothorax