What is pneumothorax ?
A pneumothorax occurs when air enters the pleural space, the area between the chest wall and the lung. Air in the pleural space can build up and press against the lung, causing it to collapse partially or fully. Pneumothorax needs immediate medical care.
What are the different types of pneumothorax ?
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Primary spontaneous pneumothorax: Collapsed lung sometimes happens in people who don’t have other lung problems. It can occur due to abnormal air sacs in the lungs that break apart and release air.
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Secondary spontaneous pneumothorax: Several lung diseases may cause a collapsed lung. These include chronic obstructive pulmonary disease (COPD), cystic fibrosis and emphysema.
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Injury-related pneumothorax: Injury to the chest can cause collapsed lung. Some people experience a collapsed lung due to a fractured rib, a hard hit to the chest or a knife or gunshot wound.
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Iatrogenic pneumothorax: After certain medical procedures such as lung biopsy or a central venous line insertion, some people can have complications that include a pneumothorax.
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Catamenial pneumothorax: This rare condition affects women who have endometriosis. Endometrial tissue lines the uterus. With endometriosis, it grows outside the uterus and attaches to an area inside the chest. The endometrial tissue forms cysts that bleed into the pleural space, causing the lung to collapse.
What causes a collapsed lung ?
Pneumothorax has three main causes: medical conditions, injuries and lifestyle factors.
Medical conditions that may cause a pneumothorax include:
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Chronic obstructive pulmonary disease (COPD).
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Cystic fibrosis.
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Endometriosis in the chest.
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Acute respiratory distress syndrome (ARDS), a condition caused by pneumonia, coronavirus and other illnesses.
Injuries that may cause pneumothorax are:
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Blunt force trauma.
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Certain types of ventilation or changes to ventilation.
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Gunshot wound.
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Lung puncture during a medical procedure, like a biopsy or nerve block.
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Stab wound.
Lifestyle factors associated with pneumothorax are:
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Drug use, especially inhaled drugs.
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Flying that involves drastic changes in air pressure.
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Scuba or deep-sea diving.
People with certain other risk factors may be more likely to have a pneumothorax. These are:
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Family history of pneumothorax.
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Pregnancy.
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Tall, thin body type.
What are the symptoms of collapsed lung ?
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A collapsed lung can have many signs and symptoms. If you have symptoms of a collapsed lung, go to the emergency room. You may need immediate care.
Signs of a pneumothorax include:
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Sudden sharp chest pain on one side especially when taking deep breaths or cough
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Fast breathing.
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Fast heart rate.
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Skin that appears blue (due to lack of oxygen)
How is pneumothorax diagnosed ?
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History
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Physical Examination
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Chest X ray
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CT scan or Ultrasound of chest
How is Pneumothorax treated ?
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Your treatment depends on the cause, size and severity of your pneumothorax. Collapsed lung treatment may include:
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Observation: If your pneumothorax is minor, your doctor may watch you for signs of heart or breathing problems. You will see your doctor for a follow-up visit.
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Supplemental oxygen: Your doctor may give you extra oxygen if your pneumothorax is small but you have symptoms.
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Needle aspiration: During aspiration, a doctor uses a syringe to remove some of the air in the pleural space. He may follow needle aspiration with percutaneous chest tube drainage.
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Chest tube drainage: If you have a larger pneumothorax, your doctor may put a hollow tube in your chest to reduce the air in the pleural space. As the air pressure decreases, the lung re-expands and heals. You may have this tube in place for a couple of days or longer.
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Chemical pleurodesis: To prevent the lung from collapsing again, your doctor may perform pleurodesis. He makes an incision, inserts a tube and then uses chemicals (such as doxycycline or talc) to attach the lung to the chest cavity, eliminating extra space in the chest cavity.
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Surgery: Video-assisted thoracoscopic surgery (VATS) is a minimally invasive procedure that uses a small camera to help the surgeon remove lung tissue.
Can I prevent a pneumothorax ?
If you have certain medical conditions or a family history of pneumothorax, you might not be able to prevent a collapsed lung.
Anyone can take steps to reduce your chances of pneumothorax:
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Avoid or limit activities with drastic changes in air pressure (scuba diving and flying). Follow your doctor’s recommendations if you do these activities.
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See your doctor regularly to monitor any lung conditions.
What is the outlook for collapsed lung ?
Most people who have a collapsed lung generally heal without major treatment. If you’ve had a collapsed lung, you have a higher chance of having it again.