Cases of spontaneous pneumothorax are being reported with increasing frequency, due to a greater familiarity with the condition on the part of the medical profession as a whole and to the more frequent performance of roentgen examination. Such an examination is absolutely essential to clinch the diagnosis.
The condition, however, is still rarely reported in infants and children, especially the so-called valvular, or tense, pneumothorax. This is the type in which the intrapleural pressure remains above atmospheric pressure in both phases of quiet respiration. It is the result of a one way valve action through a rent in the visceral pleura. Forceful inspiratory effort, as in crying, pumps enough air into the pleural space to exert a positive pressure during the inspiratory phase of quiet breathing. This trapped air gradually reduces the vital capacity, which in turn stimulates greater respiratory effort, and a vicious circle results. The end effect of
ELLISON RT, CARABELLI AA. TENSE PNEUMOTHORAX IN AN INFANTSUCCESSFUL TREATMENT BY THE PRODUCTION OF CHEMICAL PLEURITIS. Am J Dis Child. 1940;60(3):644–651. doi:10.1001/archpedi.1940.02000030176019