ABSTRACT

Background: Patients with Duchenne muscular dystrophy commonly needs non-invasive ventilation, which increases risk of secondary spontaneous pneumothorax. Clinical case: Male patient, 24 years old, with Duchenne muscular dystrophy and long term use of non-invasive ventilation. He presented bilateral and synchronic pneumothorax, managed with pleurostomy and bed pleurodesis. Nevertheless six weeks later he presented recurrence of left pneumothorax, so we performed bullectomy with video assisted thoracoscopic surgery and 8 weeks after this the right side also presented pneumothorax, giving the same manage. The patient recovered well and has not presented recurrence in eighteen month of follow up. Discussion and conclusions: Recurrence of secondary spontaneous pneumothorax occurs in approximately 50% of cases. After the first episode of spontaneous pneumothorax surgical management is recommended, because morbidity and mortality is up to 4 times higher in the second episode. In this case the surgical management with thoracoscopic was effective, secure and well tolerated. More patients are required to give consistency to the findings as well as a comparative clinical study of existing therapies to emit a recommendation.

KEYWORDS

Duchenne muscular dystrophy, secondary spontaneous pneumothorax, VATS.

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