Introduction:
E-cigarettes are a popular alternative to traditional nicotine containing cigarettes. The operational mechanism for e-cigarettes involves heating a liquid to produce an aerosol that can be inhaled into the lungs (1). A potential draw to e-cigarettes is the capability of the liquid to contain various chemical compounds ranging from nicotine to tetrahydrocannabinol (THC) and cannabinoids (CBD) oils that can be mixed with additives and flavors (1). However, there are potential consequences though that need to be considered. A now commonly recognized pathology is e-cigarette/vaping associated lung injury (EVALI/VALI). This was first described in 2019 and by the end of that year, a reported 2807 patients were admitted for EVALI with a total of 68 deaths (2). EVALI is an important consideration in the pediatric realm as adolescents have easy access to electronic cigarettes. The median age of admitted patients was 21 years old with a male predominance (2). Since this is a relatively new diagnosis, there are no prospective studies on the long term impacts on pulmonary health. Recent issues have started to take precedence and to be more recognized in literature, such as spontaneous pneumothorax related to e-cigarette use. Here we present a case of recurrent complicated pneumothorax requiring surgical intervention in an otherwise healthy 15-year-old female with a significant vaping history.