Primary spontaneous pneumothorax (PSP) in pediatric patients is less common than in adults. Tall, thin adolescent males are most commonly affected. While clinical guidelines exist for the adult population, evidence-based recommendations for management of this condition by major respiratory and pediatric societies are lacking. Apparent causes of spontaneous pneumothorax are usually not easily recognized, leading to erroneous classification. Secondary causes must be evaluated carefully before the term PSP is used, as pneumothorax may be a presenting sign for a number of different disorders. Childhood asthma, for example, may be associated with severe hyperinflation, even despite normal spirometry in some situations, which can lead to air leak syndromes, including both pneumothorax and/or pneumomediastinum. In this report, we seek to present a concise review of the current literature, review our own institutional experience with the management of pediatric PSP, and provide insight into the role that asthma may play in pediatric secondary spontaneous pneumothorax.
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