Bilateral pneumothorax and ulcerative colitis

Background. - Respiratory diseases associated with ulcerative colitis are rare. Case report. - A 14-year-old girl with ulcerative colitis was admitted for a left pneumothorax. She was given corticoidsteroids and enemas of 5 aminosalicylic acid. The pneumothorax was not controlled by pleural drainage and a pleural irritation was performed under thoracoscopy. Recurrence of pneumothorax led to surgical pleurectomy. The following day, a right pneumothorax occurred, also requiring pleurectomy. The pulmonary biopsies showed constrictive bronchiolitis. A restrictive syndrome was confirmed by functional pulmonary examinations. Total colectomy was performed nine months later for the ulcerative colitis. Comments. - Ulcerative colitis can be associated with bronchial pathology (bronchitis, bronchiectasis). Occurrence of pneumothorax has never been described; it can be a fortuitous association, but the histological features are not very different from those described in association with ulcerative colitis. The treatment of pneumothorax is difficult if the ulcerative colitis requires corticosteroids.