SIMULTANEOUS BILATERAL SPONTANEOUS PNEUMOTHORAX

We describe 12 patients with simultaneous bilateral spontaneous pneumo thorax (SBSP). They represent 4 percent of patients with spontaneous p neumothorax seen at our hospital from 1971 to 1990. Five of the 12 had no underlying lung disease. In the seven remaining patients, SBSP was secondary to histiocytosis X, lymphangioleiomyomatosis, osteogenic sa rcoma with pleural and pulmonary metastases, Hodgkin's disease, mesoth elioma, cystic fibrosis, or miliary tuberculosis. Nineteen of the 56 p atients with SBSP (34 percent) described in the literature (this serie s included) had pulmonary disease related to disorders of cells of mes enchymal origin. Emphysema and bullous lung disease were not associate d with SBSP. Long-term prognosis was a function of pulmonary status. F our of the patients described herein died during the period reviewed. All suffered from severe underlying disease. In no case was SBSP the m ain cause of death. With timely treatment, the short-term prognosis is benign even for patients with underlying lung disease. Surgical pleur ectomy should be attempted early, especially in SBSP secondary to unde rlying lung disease.