From the comments, we noticed almost every patient didn’t know about this disease at the time of onset:”I had never heard of this disease before I suffered from chest pain and was diagnosed after a chest X-ray”

Spontaneous pneumothorax is a condition where air leaks from the lungs without any evidence of trauma and the air accumulates in the pleural cavity. Spontaneous pneumothorax can be divided into two groups, primary spontaneous pneumpthorax, without any obvious lung disease, and secondary spontaneous pneumothorax, related to lung disease.

According to statistics, the incidence of spontaneous pneumothorax is 1 to 7 people per hundred thousand.  People who are tall and thin, who smoke and who have a family history tend to suffer from spontaneous pneumothorax. Commonly the first symptoms are chest pain, shortness of breath and /or a cough. Generally the patient feels anxious, helpless and troubled. But, a definite diagnosis can be made only by a simple chest X-ray.

The diagnosis is easy to make, but the declining patient-physician relationship and lack of mutual confidence cause difficulties . One comment from a patients’ family member revealed his suspicion.

:”                   on Jan. 1, 2000 my family member was sent to xx hospital in Chung-Li. At 3:50 PM a chest X-ray revealed pneumothorax, a disease I have never heard of before. When I arrived at the hospital from Yi-Lang at 8 PM, the operation had already been completed. …………… I would like to ask you a question: the first is ‘did spontaneous pneumothorax have to be treated so quickly?’….”. ”I would like to ask one question : why does almost every case result in operation or medication from the onset the disease?” ”Why, when a doctor sees my X-ray, does he/she always suggest an emergent operation due to the severity of my disease?”. In general . after his/her first attack , a patient will be treated by bed rest, observation and percutaneous aspiration if the symptoms are mild( not more than 20% pneumothorax deterioration ). Otherwise, one with more obvious symptoms, including an extended deterioration area of pneumothorax, contralateral lung disease or more than 20% pneumothorax, contralaterral lung disease or more than 20% pneumothorax should be treated with tube thoracostomy. Thoracotomy will be necessary if air leakage persists, if the lung collapes, if hemothorax develops or if tension pneumothorax exists.  If this attack is not first , the chance of recurrence will increase . So most surgeons will initially suggest thoracotomy in these cases.