Pediatric Spontaneous Pneumothorax

  • Etiology: Ruptured subapical bleb or bullae
  • Imaging CT: Subapical bleb or bullae
  • DDX:
  • Complications: 16-52% recur
  • Treatment: Surgical resection of subapical bleb or bullae
  • Clinical: Occurs in teenager who are tall and thin

Radiology Cases of Spontaneous Pneumothorax

CXR and CT of spontaneous pneumothorax due to apical bleb
CXR PA (above left) shows a large amount of air in the right pleural space with some mediastinal shift to the left. There is a round cystic structure in the right lung apex. Coronal (above right) and axial (below) CT without contrast of the chest shows the cystic structure to be a large bleb in the apex of the right lung.
CT of spontaneous pneumothorax due to apical bleb
Axial CT with contrast of the chest at presentation (above) shows a large amount of air in the right pleural space which was subsequently treated with a chest tube. Coronal CT without contrast of the chest performed 1 week after presentation and after chest tube removal (below) shows a small bleb in the apex of the right lung.