A Pneumothorax (Pneumo + Thorax) is an abnormal collection of air or gas in the pleural space that causes an uncoupling of the lung from the chest wall. Like pleural effusion (liquid buildup in that space), pneumothorax may interfere with normal breathing.
A primary pneumothorax is one that occurs without an apparent cause and in the absence of significant lung disease, while a secondary pneumothorax occurs in the presence of existing lung pathology.
Facts
1. A Pneumothorax is a collection of free air in the chest cavity (thoracic cavity) that causes the lung to collapse.
2. Pneumothorax may also occur as a consequence of an injury or underlying lung disease.
3. Pneumothorax may occur on its own in the absence of underlying disease; this is termed spontaneous pneumothorax.
4. Treatment may include insertion of a chest tube or aspiration of the free air in the chest cavity.
Types
1. Traumatic Pneumothorax
This occurs when an injury to the chest (as from a car wreck or gun or knife wound) causes the lung to collapse.
2. Tension Pneumothorax
This type can be fatal. It occurs when pressure inside the pleural cavity is greater than the outside atmospheric pressure. It can force the entire lung to collapse and can push the heart toward the lung, putting pressure on both.
3. Primary Spontaneous Pneumothorax
This happens when a small air bubble on the lung ruptures. These may happen for no obvious reason or while undergoing changes in air pressure (like when scuba diving or mountain climbing).
4. Secondary Spontaneous Pneumothorax
This typically happens to those who already have lung disease. As the lung is already compromised by disease and may have diminished capacity, this can be a serious complication.
Causes
Common causes of Pneumothorax are :
1. Penetrating chest injury or trauma
2. Atmospheric overpressure
3. Pre-existing lung disease
Signs and Symptoms
1. Chest pain usually has a sudden onset.
2. Breathlessness
3. Rapid heart rate
4. Rapid breathing
5. Cough
6. Fatigue
7. Skin may develop a bluish color (termed cyanosis) due to decreases in blood oxygen levels.
Diagnosis
1. Chest X-ray
2. Computed tomography
3. Ultrasound
Treatment
A small pneumothorax without underlying lung disease may resolve on its own in one to two weeks. A larger pneumothorax and a pneumothorax associated with underlying lung disease often require aspiration of the free air and/or placement of a chest tube to evacuate the air. Possible complications of chest tube insertion include pain, infection of the space between the lung and chest wall (the pleural space), hemorrhage (bleeding), fluid accumulation in the lung, and low blood pressure (hypotension). In some cases, the leak does not close on its own. This is called a bronchopleural fistula, and may require chest surgery to repair the hole in the lung.
A primary pneumothorax is one that occurs without an apparent cause and in the absence of significant lung disease, while a secondary pneumothorax occurs in the presence of existing lung pathology.
Facts
1. A Pneumothorax is a collection of free air in the chest cavity (thoracic cavity) that causes the lung to collapse.
2. Pneumothorax may also occur as a consequence of an injury or underlying lung disease.
3. Pneumothorax may occur on its own in the absence of underlying disease; this is termed spontaneous pneumothorax.
4. Treatment may include insertion of a chest tube or aspiration of the free air in the chest cavity.
Types
1. Traumatic Pneumothorax
This occurs when an injury to the chest (as from a car wreck or gun or knife wound) causes the lung to collapse.
2. Tension Pneumothorax
This type can be fatal. It occurs when pressure inside the pleural cavity is greater than the outside atmospheric pressure. It can force the entire lung to collapse and can push the heart toward the lung, putting pressure on both.
3. Primary Spontaneous Pneumothorax
This happens when a small air bubble on the lung ruptures. These may happen for no obvious reason or while undergoing changes in air pressure (like when scuba diving or mountain climbing).
4. Secondary Spontaneous Pneumothorax
This typically happens to those who already have lung disease. As the lung is already compromised by disease and may have diminished capacity, this can be a serious complication.
Causes
Common causes of Pneumothorax are :
1. Penetrating chest injury or trauma
2. Atmospheric overpressure
3. Pre-existing lung disease
Signs and Symptoms
1. Chest pain usually has a sudden onset.
2. Breathlessness
3. Rapid heart rate4. Rapid breathing
5. Cough
6. Fatigue
7. Skin may develop a bluish color (termed cyanosis) due to decreases in blood oxygen levels.
Diagnosis
1. Chest X-ray
2. Computed tomography
3. Ultrasound
Treatment
A small pneumothorax without underlying lung disease may resolve on its own in one to two weeks. A larger pneumothorax and a pneumothorax associated with underlying lung disease often require aspiration of the free air and/or placement of a chest tube to evacuate the air. Possible complications of chest tube insertion include pain, infection of the space between the lung and chest wall (the pleural space), hemorrhage (bleeding), fluid accumulation in the lung, and low blood pressure (hypotension). In some cases, the leak does not close on its own. This is called a bronchopleural fistula, and may require chest surgery to repair the hole in the lung.
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