A deep azygoesophageal recess may increase the risk of secondary spontaneous pneumothorax

Tsuyoshi Takahashi, Mitsuaki Kawashima, Hideki Kuwano, Kazuhiro Nagayama, Jyunichi Nitadori, Masaki Anraku, Masaaki Sato, Tomohiro Murakawa, Jun Nakajima

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1 Scopus citations


Purpose: The azygoesophageal recess (AER) is known as a possible cause of bulla formation in patients with spontaneous pneumothorax. However, there has been little focus on the depth of the AER. We evaluated the relationship between the depth of the AER and pneumothorax development. Methods: We conducted a retrospective study of 80 spontaneous pneumothorax patients who underwent surgery at our institution. We evaluated the depth of the AER on preoperative computed tomography scans. Results: Ruptured bullae at the AER were found in 12 patients (52.2%) with secondary spontaneous pneumothorax (SSP) and 8 patients (14.0%) with primary spontaneous pneumothorax (PSP) (p < 0.001). In patients with ruptured bullae at the AER, 10 SSP patients (83.3%) had a deep AER while only 2 PSP patients (25%) had a deep AER (p = 0.015). Conclusions: A deep AER was more frequently associated with SSP than with PSP. A deep AER may contributes to bulla formation and rupture in SSP patients.

Original languageEnglish
Pages (from-to)1147-1152
Number of pages6
JournalSurgery Today
Issue number9
StatePublished - Sep 1 2017


  • Emphysema/bullae
  • Mediastinum pneumothorax


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