The association between a spontaneous pneumothorax and an azygos lobe
is surprisingly rare. A case is reported in which surgical management
was difficult; it is suggested that thoracotomy is preferable to video
-assisted thoracoscopic surgery in this situation. It is possible that
the presence of an azygos lobe might protect against the subsequent d
evelopment of a spontaneous pneumothorax, and the possible mechanism o
f this is discussed.