Congenital Pleuro-Pleural Communication Presenting as a Simultaneous Bilateral Spontaneous Pneumothorax: A Case Report

Bilateral spontaneous pneumothorax is a rare condition that accounts for approximately 1% of all pneumothorax cases. Most cases are attributed to underlying lung disease or prior thoracic surgery, as congenital pleuro-pleural communication is rare. We report the case of a 15-year-old girl with bilateral pneumothorax who underwent video-assisted thoracoscopic surgery. Intraoperative air leak testing unexpectedly revealed congenital pleuro-pleural communication. A retrospective review of preoperative computed tomography suggested a potential bilateral pleural communication between the esophagus and aorta. No intervention was performed to close the communication because of the technical challenges of achieving an airtight seal. The patient's postoperative course was uneventful, with no recurrence after 6 months. This case emphasizes the need to consider congenital pleuro-pleural communication in cases of bilateral pneumothorax, particularly in patients without prior thoracic surgery or bilateral bullae.