The etiology and treatment of spontaneous pneumothorax.

In the past year, studies on spontaneous pneumothorax have focused on etiology and treatment. Chronic obstructive pulmonary disease remains the most common cause of secondary spontaneous pneumothorax. However, Pneumocystis carinii infections in patients who have AIDS have become the leading cause of spontaneous pneumothorax in a population where its prevalence is high. One of the treatment modalities of spontaneous pneumothorax is tube thoracostomy with the instillation of tetracycline as the sclerosing agent. Tetracycline is no longer available. Fortunately, its derivatives doxycycline and minocycline are equally effective. Talc in slurry or insufflated appears to be more effective than tetracycline derivatives. Experience with talc in slurry for the treatment of spontaneous pneumothorax is still limited. Another treatment modality for spontaneous pneumothorax is thoracoscopy, more recently termed video-assisted thoracic surgery, and it has warranted renewed interest due to the advent of improved endoscopic technology. In the treatment of spontaneous pneumothorax, video-assisted thoracic surgery is nearly as effective as thoracotomy.