Spontaneous pneumothorax comprises app. 0.1–2 % of surgical diseases. There are four subtypes; primary,
secondary, catamenial and neonatal. Aetiology of primary pneumothorax is not exactly known since there is no direct
relation to any basic lung disease. Nevertheless, in most patients (80–85 %), it develops due to the rupture of an
emphysematous bulla or a subpleural air bubble, i.e. blebs. On the other hand, secondary pneumothorax is a result or
a complication of a verified localized or general lung disorder. Catamenial pneumothorax is a recurrent lung collapse
in women at the time of menstruation. Neonatal pneumothorax is found typically in immature or premature newborns,
often in association with congenital lung disorders. From the pathological point of view, it is an acute disorder of
distribution of blood gasses in lungs with subsequent hypoxemia, which can be identified as an acute thoracic event.
The clinical picture of pulmonary collapse is characterised by a triad of symptoms – dyspnoea, pleuritic pain and dry
and non-productive cough. The diagnosis is usually determined on the base of history and after a careful clinical
examination. It is then verified on lung X-ray. The objective of therapy of spontaneous pneumothorax is to restore
permanent lung expansion to the original extent. Conservative treatment is chosen in the first episodes of
pneumothorax with small extent and without further complications or symptoms. In the rest of cases, the surgical
treatment is necessary, which includes puncture of the pleural cavity, drainage and surgical revision using
videothoracoscopy or thoracotomy. In general, in case of the first episode of pulmonary collapse it is recommended
to perform less radical procedure, i.e. drainage of the pleural cavity. Recurrences of the disease are indicated for
surgical treatment; primarily miniinvasive procedures, in which the site of air leaking from lung parenchyma is closed
and also an artificial pleural symphysis is created to prevent recurrence of the collapse. This type of procedure
provides best results; recurrence is not exceeding 3%.
spontaneous pneumothorax, drainage, videothoracoscopy.