Recurrent Spontaneous Pneumothorax in a Nine-Year-Old Patient.

Spontaneous pneumothorax is defined as lung collapse due to air accumulation in the pleural space without trauma or iatrogenic causes and is rare in the pediatric population, with an incidence of approximately 1-4 per 100,000 children. Management strategies are largely extrapolated from adult guidelines, and pediatric evidence is primarily limited to case reports. We report a case of a nine-year-old boy who presented with sudden-onset pleuritic chest pain and was diagnosed with a large right-sided spontaneous pneumothorax. Initial management involved chest tube insertion, and subsequent computed tomography revealed right-sided congenital bullae located in the apical segment of the right lower lobe. Ten days later, the patient developed an early ipsilateral recurrence, prompting video-assisted thoracoscopic surgery with bullectomy and pleurodesis. This case highlights the challenges of managing pediatric spontaneous pneumothorax in the absence of standardized pediatric guidelines and suggests that early imaging and individualized consideration of surgical intervention may help reduce recurrence risk. The development of pediatric-specific management guidelines is warranted.