PMC7551981_01
A: Chest X-ray PA view shows large right pneumothorax with signs of impending tension.. B: Total re-expansion of the right lung with chest tube in proper position.. C: Chest CT scan shows bilateral apical subpleural blebs.
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Supplemental oxygen started by nasal cannula and Oxygen saturation raised to 95% then a standing poster-anterior chest X-ray (PA) view was obtained and showed right side large pneumothorax with underlying lung collapse, mediastinum was in normal position with normal left lung (Fig. 1A).
Left upper lobe apical bleb, thoracoscopic view.
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Under general anesthesia VATS reveled ruptured right upper lobe apical bleb which was excised, the diaphragm was checked for any depositions, then mechanical pleural abrasion was performed, chest tube placed, we didn't use talc because we think in the age group still not advisable (Fig. 2).
Left metachronous large pneumothorax.
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Chest x-ray revealed large left-side pneumothorax, and right side normal (Fig. 3A).
Schematic presentation for the site of the blebs.
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The position of the blebs is demonstrated schematically in Fig. 4.