SURGICAL TREATMENT OF SPONTANEOUS PNEUMOTHORAX CAUSED BY RIB EXOSTOSIS
Abstract
The most common cause of spontaneous pneumothorax is subpleural emphysematous bullae. Rib exostoses are extremely rare causes of pleural-pulmonary complications. They can lead to hemothorax, pneumothorax, hemopneumothorax, and rupture of the diaphragm or pericardium. Exostoses occur either sporadically or as a manifestation of a genetic disorder known as hereditary multiple exostoses. The article presents a successful experience of surgical treatment of an 18-year-old patient with spontaneous pneumothorax caused by exostosis of the 5th rib. Upon admission, the patient complained of coughing, shortness of breath, and fever. A spiral computed tomography scan of the chest was performed. The patient was diagnosed with right-sided spontaneous pneumothorax, acicular exostosis of the anterior segment of the 5th rib on the right side with penetration into the parenchyma of the middle lobe of the right lung, and infiltrative changes in the middle and lower lobes. After conservative therapy and normalization of the patient's condition, a mini-invasive operation was performed: video-assisted subperiosteal resection of the 5th rib and marginal resection of the middle lobe of the right lung. The postoperative course was uncomplicated. The patient was discharged on the 5th day after the operation.
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