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\title{High Resolution CT following Primary Spontaneous Pneumothorax in
Adolescents: Useful tool or wasted radiation? Dr. Sarah Stanko, MD
University of Arizona, Dr. Colette Oesterle, MD University of Arizona,
Dr. Merlin Lowe, MD University of Arizona Keywords: primary spontaneous
pneumothorax, pneumothorax, bleb, adolescent, pediatrics, chest tubes
Correspondence: Dr. Merlin Lowe Dept. of Pediatrics 1501 N. Campbell
Ave. Tucson, AZ 85724 520-626-6614 520-626-2883 lowe@peds.arizona.edu}



\author[1]{Sarah Stanko}%
\author[2]{Merlin Lowe}%
\author[1]{Colette  Oesterle}%
\affil[1]{University of Arizona Medical Center - Diamond Children's}%
\affil[2]{The University of Arizona College of Medicine Tucson}%


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  \date{May 08, 2024}


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\begin{abstract}
Background The current trend in management of first-time primary
spontaneous pneumothorax (PSP) in children is to obtain a high
resolution chest computerized tomography (HRCT) scan to look for
bleb/bullae disease or other structural lung disease. We aimed to
evaluate the significance of HRCT findings in relation to initial
management strategies, and we hypothesized that these findings do not
guide management. Methods We evaluated patients with first time PSP in a
single-institution, retrospective, longitudinal study. The primary
endpoint was the percentage of patients who underwent surgical
intervention after HRCT. Results We identified ten children from 10-17
years old from January 2013 to November 2019 who met criteria for the
study. Seven out of ten patients (70\%) had HRCT after first-time PSP
during the same hospital stay. Blebs/bullae were discovered in five out
of seven (71\%) of those patients. Two of those five patients had
subsequent surgical intervention (40\%). 28\% of those who had a HRCT
had surgery at that point. Of those treated conservatively with
blebs/bullae identified on HRCT, 66\% had recurrence of PSP and all
patients subsequently underwent VATS with blebectomy and pleurodesis.
Among the patients without initial HRCT, there were no recurrent cases
of PSP noted. Conclusions There is value in obtaining HRCT after the
first time PSP, as these results can be used to guide management
strategies. Further studies in pediatric PSP are needed to validate the
sensitivity of HRCT in bleb detection, the predictive value of bleb
disease and recurrence, and the benefits and risks of early surgical
intervention%
\end{abstract}%



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