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Johns Hopkins Symptoms and Remedies

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Pneumothorax

In traumatic pneumothorax, air enters the pleural cavity upon inspiration and exits on expiration, while the lung remains deflated. Tension pneumothorax results when air cannot escape during expiration.

What is it?

Pneumothorax is an accumulation of air in the space between the outer edge of the lung and the inner lining of the rib cage (pleural space), resulting in partial or total collapse of the affected lung. Different types of pneumothorax (spontaneous, secondary, traumatic, and tension) are distinguished by their cause. Treatment and outcome depend upon severity.

What Causes It?

  • Spontaneous pneumothorax occurs when an airfilled blister known as a bleb ruptures on the surface of the lung. Blebs are believed to be congenital or hereditary in origin; smoking may be a contributing factor. Scuba diving or high altitudes may precipitate the rupture of a bleb. This type of pneumothorax is most common among tall, thin, and otherwise healthy men between the ages of 20 and 40, and recurs in about one-third of patients.
  • Secondary pneumothorax (usually more serious than spontaneous pneumothorax) occurs as a complication of some underlying lung disorder, including chronic obstructive pulmonary disease, cystic fibrosis, tuberculosis, and certain types of pneumonia.
  • Traumatic pneumothorax results from a direct puncture or laceration of the surface of the lung (which may occur with a stab wound, a rib fracture, or as a complication of a medical procedure) when air enters the pleural space.
  • A tension pneumothorax develops when air entering the pleural space during inhalation becomes trapped and cannot escape during exhalation.

Prevention

  • Don't smoke.
  • Seek prompt treatment for any existing lung disorders, such as tuberculosis or asthma.

Diagnosis

  • Patient history, examination, and chest x-rays.

How to Treat It

  • A small pneumothorax may heal on its own; a few days of monitoring in a hospital may be advised.
  • More serious cases may require removal of air by suction through a needle or catheter. Using this procedure, the lung usually reexpands over several days.
  • Recurrent spontaneous pneumothorax may warrant installation of irritants into the pleural space to cause the surface of the lung and the inner surface of the chest wall to fuse together.
  • Surgery may be considered to repair a lung lesion causing secondary pneumothorax.

When to Call a Doctor

  • See a doctor immediately if you have symptoms.