Abstract
We report a case of bilateral spontaneous pneumothorax with critical collapse of both lungs in a previously healthy 33-year-old man. During the right-sided bullectomy, washing fluid flowed into the left thoracic cavity. Thereafter, thoracography confirmed a communication with bilateral pleural spaces. Careful thoracoscopic inspection revealed a 1.5-cm-long pleural window posterior to the inferior pulmonary ligament and located between the aorta and esophagus. Direct suturing followed by packing with a polyglycolic acid sheet and fibrin glue was performed to close the pleural window. The postoperative course was uneventful.