Pneumothorax

Pneumothorax

What is a pneumothorax?

A pneumothorax is a collection of free air in the chest outside the lung that causes the lung to collapse.

Types of pneumothorax

A spontaneous pneumothorax, also referred to as a primary pneumothorax, occurs in the absence of a traumatic injury to the chest or a known lung disease. A secondary (also termed complicated) pneumothorax occurs as a result of an underlying condition.

Causes

• Spontaneously (more commonly in tall slim young males and in Marfan syndrome)
• Following a penetrating chest wound
• Following barotrauma to the lungs^[2][3]

It may also be due to:

• Chronic lung pathologies including emphysema, asthma
• Acute infections
• Chronic infections, such as tuberculosis
• Lung damage caused by cystic fibrosis
• Lung Cancer
• Rare diseases that are unique to women such as Catamenial pneumothorax (due to endometriosis in the chest cavity) and lymphangioleiomyomatosis (LAM).

Symptoms

Almost everyone who has a collapsed lung has the following symptoms:

• Sharp chest pain, made worse by a deep breath or a cough
• Shortness of breath

A larger pneumothorax will cause more severe symptoms, including:

• Chest tightness
• Easy fatigue
• Rapid heart rate
• Bluish color of the skin caused by lack of oxygen

Note: Symptoms may begin during rest or sleep.

Other symptoms that can occur with a collapsed lung include:

• Nasal flaring
• Low blood pressure (hypotension)

Investigations

• Chest x-ray to tell whether there is air outside the lung
• Arterial blood gases

Treatment

A small pneumothorax may go away on its own. You may only need oxygen and rest. The health care provider may use a needle to pull the extra air out from around the lung so it can expand more fully. You may be allowed to go home if you live near the hospital.

If you have a large pneumothorax, a chest tube will be placed between the ribs into the space around the lungs to help drain the air and allows the lung to re-expand.

The chest tube can be left in place for several days. You must stay in the hospital while the chest tube is in place.

Some patients with a collapsed lung need extra oxygen, which helps the air around the lung be reabsorbed more quickly.

Lung surgery may be needed to treat your pneumothorax or to prevent future episodes. The area where the leak occurred may be repaired. Sometimes, a special chemical is placed into the area of the collapsed lung. This chemical causes a scar to form.

Expectations (prognosis)

If you have a collapsed lung, you are more likely to have another one in the future if you:

• Are tall and thin

• Continue to smoke

• Have had two collapsed lungs in the past

How well a person does after having a collapsed lung depends on what caused it.

Complications

• Another collapsed lung in the future

• Shock

Posted in: Pneumothorax,Respiratory System