PRIMARY SPONTANEOUS PNEUMOTHORAX IN MEN

To determine the risk factors, clinical presentation, and long-term ou tcome of primary spontaneous pneumothorax (PSP), all available cases o f PSP in the Israeli Defense Forces (IDF) were retrospectively reviewe d. Using the computerized IDF database, all men who had pneumothorax w ere identified and a telephone interview obtained with 343 individuals , 286 of whom had PSP and agreed to participate in this study. These 2 86 persons experienced 498 episodes of PSP, with 314 medical records a vailable for review. Average length of follow-up from the first episod e of PSP was 107.2 months. Of the study population, 11.5% had a positi ve family history for PSP. The height-to-weight ratio was significantl y and positively correlated with the number of PSP episodes per person , with the regression coefficient being 0.49. The age distribution of those with PSP had a monophasic pattern, with the average age being 25 .3 years on first episode. More than one episode of PSP occurred in 41 .3% of patients. No ipsilateral recurrences were observed after surger y. Treatment with a sclerosing agent seemed to be more effective in pr eventing ipsilateral recurrences of PSP than chest tube insertion alon e (26.5% vs. 38.3%). Primary spontaneous pneumothorax is an important medical problem, especially in men of military age. It has a significa nt inherited component in its etiology, with asthenic body build being an additional risk factor. Based on a literature review and the data obtained from this study, it was concluded that chest tube insertion w ith intrapleural instillation of a sclerosing agent is the preferred n onsurgical invasive treatment modality in PSP.