Chest
Volume 116, Issue 4, October 1999, Pages 899-902
Journal home page for Chest

Clinical Investigations
Surgery
Physical Development of Surgically Treated Patients With Primary Spontaneous Pneumothorax

https://doi.org/10.1378/chest.116.4.899Get rights and content

Study objectives

There have been many studies on the physical characteristics at the time of contraction of a primary spontaneous pneumothorax (PSP), but it has not been shown when and how such physical characteristics develop. These issues were investigated.

Patients and design

Physical development of 27 male patients with PSP were examined. Their physical records were collected with the patients’ permission, and standard curves, estimated from the Japanese nationwide records in the year corresponding to the ages of the patients, were plotted as control values.

Results

The height of patients was already greater at 6 years of age. It showed a marked increase from 11 to 14 years. The body weight was more than the standard until 9 years, but it became less after age 11, and this difference increased after age 15. Rohrer's index was significantly lower than the standard at all ages, and the difference was particularly large from 11 to 15 years. In the standard group, there was a balance between the annual height and weight gain. In the patient group, annual weight gain was similar to that in the standard group whereas height began to increase 2 years earlier, and as a result, ectomorphy, which was also observed before this age, became marked at this age.

Conclusions

The rapid increase in the vertical dimension of the thorax compared with the horizontal dimension during the period of rapid physical development is considered to affect intrathoracic pressure at the apex of lung, which would have some influence on enhancing cyst formation.

Section snippets

Materials and Methods

Of 95 patients with PSP who were treated surgically during a study period of 7 years in our hospital, 27 male patients whose physical development could be examined participated in the present study. Four female patients whose physical development could be examined were not included in this study.

The backgrounds of the 95 patients were as follows. The right side was surgically treated in 48 patients, the left in 43 patients, and both in 4 patients. The patients consisted of 78 men and 17 women.

Results

Because schools in Japan are allowed to discard physical records of the students 5 years after their graduation, complete records from primary to senior high school could be examined in only 31 young patients. Of these 31, 27 male patients were examined in this study. Because some low- and middle-teenage patients were included in this group, the overall number of patients examined was 27 in the age group from 6 to 11 years, 26 from 12 to 13 years, 25 at 14 years, 24 at 15 years, 23 at 16 years,

Discussion

Most cases of spontaneous pneumothorax were regarded as being secondary to pulmonary tuberculosis, until 1932, when Kjaergard6 described PSP as a separate entity occurring in previously healthy adults. As noted in the article by Withers et al,7 Devilliers was the first to suggest the rupture of subpleural blebs as a cause for spontaneous pneumothorax. Since then, there have been many studies on factors related to the formation and rupture of subpleural cysts.

West8 showed that the size of

Summary

Physical development was investigated in patients with PSP, and the following results were obtained: (1) Patients with PSP are ectomorphic from childhood. This is primarily because of their greater than average height, but their body weight is also greater than average in early childhood. (2) This ectomorphy is further exaggerated in the period of rapid physical development as a result of more rapid increase in height than weight. (3) The rapid increase in the vertical dimension of the thorax

References (11)

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