Pulmonary air leaks resulting from outdoor sports. A clinical series and literature review.

The occurrence of pulmonary air leaks consequent to recreational sports is considered to be rare. We performed a retrospective records review for cases of pulmonary air leaks for the 5-year period 1993 to 1997 at a community hospital that serves a popular tourist destination area having intense year-round outdoor recreational activities. We identified 20 patients who had sustained a spontaneous or traumatic pulmonary air leak while engaged in an outdoor sport. All but one case (95%) were due to blunt chest trauma. A total of nine different sports were involved, but the majority of cases (11, or 55%) occurred during skiing or snowboarding. Three (15%) patients died. Nine (53%) of the surviving 17 patients sustained injuries serious enough to require hospitalization for tube thoracostomy and other trauma care. We concluded that pulmonary air leaks due to blunt chest trauma occur more frequently in outdoor sports than the literature suggests.