Value of computed tomography of the lung in the management of primary spontaneous pneumothorax.

The treatment of patients with primary spontaneous pneumothorax remains controversial, since recurrence and the ultimate need for thoracotomy [corrected] cannot be predicted. In the current study, computed tomography (CT) of the lung was performed prospectively on 26 consecutive patients with primary spontaneous pneumothorax to determine whether the size and/or the number of apical blebs would correlate with recurrence and/or need for thoracotomy [corrected]. Both the number of blebs and the bleb score (calculated by the number of blebs multiplied by a numeric value assigned a range of bleb sizes) of the affected lung was significantly greater in patients with a history of recurrent pneumothorax and/or ultimate need for thoracotomy [corrected] as treatment. CT of the lung may be useful in predicting the natural history of pneumothorax.