{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:31:53Z","timestamp":1777447913353,"version":"3.51.4"},"reference-count":4,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2022,12,17]],"date-time":"2022-12-17T00:00:00Z","timestamp":1671235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>A primary spontaneous pneumothorax (PSP) is caused by rupture of subpleural emphysematous blebs, without inciting event or pre-existing co-morbidity. A previously healthy 16-year-old male presented with upper chest pain. As expected, chest radiographs (CXR) demonstrated a 13\u00a0mm pneumothorax. Additionally, a 4.7\u00a0cm apical bleb was identified. After six-hours of observation and non-rebreather oxygen mask therapy, follow-up CXR confirmed stable findings. The patient was subsequently discharged home after symptoms improved. Follow-up CXR at 2-weeks confirmed persistent visible apical bleb. After lengthy discussion addressing patient and parental concerns, elective surgical management was pursued. Current literature suggests blebs are not routinely identified on CXR. While there is no universally accepted management algorithm for PSP in children, visible apical blebs on CXR may influence the decision to pursue surgical intervention. Shared decision making should involve counseling regarding the recurrence risk following surgery, and consideration of patient-specific factors including patient and parental anxiety.<\/jats:p>","DOI":"10.1177\/00031348221146960","type":"journal-article","created":{"date-parts":[[2022,12,17]],"date-time":"2022-12-17T10:34:15Z","timestamp":1671273255000},"page":"4981-4983","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Visible Apical Blebs on CXR: Are Plain Radiographs Under-Utilized in Primary Spontaneous Pneumothorax?"],"prefix":"10.1177","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4053-7772","authenticated-orcid":false,"given":"Dimitra M.","family":"Lotakis","sequence":"first","affiliation":[{"name":"Section of Pediatric Surgery, Department of Surgery, Mott Children\u2019s Hospital, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keoni","family":"Bailey","sequence":"additional","affiliation":[{"name":"University of Michigan Medical School, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cory","family":"Criss","sequence":"additional","affiliation":[{"name":"Section of Pediatric Surgery, Department of Surgery, Mott Children\u2019s Hospital, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. Elizabeth","family":"Speck","sequence":"additional","affiliation":[{"name":"Section of Pediatric Surgery, Department of Surgery, Mott Children\u2019s Hospital, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,12,17]]},"reference":[{"key":"bibr1-00031348221146960","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2018.0629"},{"key":"bibr2-00031348221146960","doi-asserted-by":"publisher","DOI":"10.21980\/J8RD1X"},{"key":"bibr3-00031348221146960","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2004.12.002"},{"key":"bibr4-00031348221146960","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-007-0537-7"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348221146960","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348221146960","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348221146960","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:36:15Z","timestamp":1777379775000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348221146960"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,17]]},"references-count":4,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1177\/00031348221146960"],"URL":"https:\/\/doi.org\/10.1177\/00031348221146960","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,17]]}}}