Spontaneous Bilateral Pneumothorax Resulting From Iatrogenic Buffalo Chest After the Nuss Procedure

We describe a case of iatrogenic buffalo chest resulting in spontaneous bilateral pneumothorax in a 14-year-old boy with pectus excavatum in the late postoperative period after the Nuss procedure. The patient presented with a sudden onset of dyspnea 2 months after the Nuss procedure, and a chest roentgenogram showed a bilateral pneumothorax. We performed an emergency operation and found a communication between the chest cavities and a ruptured bulla in the left lung. This case highlights the potential development of simultaneous bilateral pneumothorax caused by a communication between the chest cavities after the Nuss procedure. (C) 2014 by The Society of Thoracic Surgeons