Pneumothorax: An uncommon complication of minimally invasive parathyroidectomy

The gold standard for the surgical treatment of primary hyperparathyroidism has traditionally been bilateral neck exploration with identification of all four parathyroid glands. However, because of the increasing sensitivity and accuracy of preoperative imaging techniques, including ultrasound and sestamibi scanning, and the introduction of intraoperative parathyroid hormone monitoring, unilateral neck exploration has become more widely used. We describe two cases of pneumothorax following minimally invasive parathyroidectomy. The pneumothorax in the first case was thought to be due to the position of the parathyroid adenoma in the mediastinum and thus its close proximity to the lung pleura. In the second case, the patient had a history of emphysema, and the pneumothorax was most likely due to a rupture of a bleb. With prompt diagnosis and early treatment of this potential complication, morbidity can be decreased.