Adhesions as a cause of persistent spontaneous pneumothorax.

The authors present a case of a patient with a persistent spontaneous pneumothorax (after seven days of chest tube drainage) in whom a tear in an upper lobe bleb was held open by adhesions between the bleb and the chest wall. Radiographic findings which might indicate such a condition are presented, thus altering one to the need for early surgical intervention. Current theories regarding the pathophysiology of pneumothorax in the young and elderly patient are reviewed.