# Contralateral pneumothorax with postpneumonectomy syndrome: report of 18-year-old case

## TL;DR

An 18-year-old with a history of pneumonectomy developed a pneumothorax and successful treatment was achieved with bullectomy.

## Contribution

This case report highlights successful management of postpneumonectomy syndrome with thoracoscopic bullectomy.

## Key findings

- Right thoracoscopic bullectomy was successful in treating right pneumothorax.
- Radiological findings showed apical bullae extending into the left atrophic thoracic cavity.
- Modifications in ventilation and thoracoscope positioning were described for surgical success.

## Abstract

We herein report a case of an 18-year-old male with left postpneumonectomy syndrome who underwent a bullectomy for right pneumothorax. The patient underwent a left pneumonectomy at the age of 1 year. At the age of 18 years, he developed right pneumothorax, and radiological findings revealed apical bullae in the right pleural cavity extending into the left atrophic thoracic cavity beyond the upper mediastinum. The right thoracoscopic bullectomy was successful. Modifications of selective lobar ventilation during surgery and thoracoscope position were described.

Overextension of a remaining lung with mediastinal shift after pneumonectomy, what is called, postpneumonectomy syndrome, can lead to severe respiratory symptoms such as persistent dyspnoea, haemoptysis and cyanosis.