In urban areas, the emergency service must always be
Spontaneous pneumothorax is most common in adolescents
and young adults. Due to its tendency to recur,
spontaneous pneumothorax is sill troublesome for patients.
Bullous lesions in the apex are evaluated as risk
factors [7]. According to previous studies, the recurrence
rate would be 16% to 50% if there was no surgical intervention
[1,8-12]. With surgical treatment, its recurrence
rate becomes less than 5% [13]. However, contralateral
recurrence may also take place [2-6]. Sihoe et al. reported
that 53% of patients with spontaneous pneumothorax
were found to have contralateral bullous lesions, and it
has been identified as one of the most important risk factors
in contralateral pneumothorax [5]. Mitlehner et al.
reviewed the value of CT scan in detecting bullae and
bleb formation of the lung in 35 patients with spontaneous
pneumothorax. CT scans showed pathological lung
changes in 31 of 35 patients. Contralateral bullae and
blebs were found in 23 of them. However, no correlation
between recurrences and anatomical status such as number,
size and distribution of blebs/bullae was found [14].
In addition, some researchers indicated that lower body
mass index (BMI) was also a risk factor for bilateral and
contralateral pneumothorax [15-17]. Sadikot et al. reported
that recurrence was more common in taller men and
in women [18]. Huang et al. recently reported the spontaneous
bilateral and contralateral pneumothorax was significantly
more frequent in patients with a lower BMI [16].
They also reported that BMI lower than BMI