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Everything You Need to Know About Pneumothorax

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Everything You Need to Know About Pneumothorax

Pulmonology | Posted on 05/16/2023 by RBH



What is pneumothorax?

Pneumothorax also known as collapsed lung is a medical condition that occurs when air leaks into the space between the lung and the chest wall. It leads to lung collapse completely or partially. This condition can lead to difficulty breathing, chest pain, and other serious complications when left untreated. Pneumothorax can be caused by a variety of factors, such as lung disease, chest injury, or medical procedures like mechanical ventilation or lung biopsy.

What are the types of pneumothorax?

There are two types of pneumothorax: spontaneous and traumatic. 

  • Spontaneous pneumothorax occurs when air leaks from the lung into the pleural space without any injury or trauma to the chest. This type of pneumothorax is usually seen in tall, thin individuals, smokers, and people with underlying lung disease. 
  • Traumatic pneumothorax, on the other hand, is caused by a chest injury, such as blunt trauma or a penetrating wound.

What are the symptoms of pneumothorax?

The pneumothorax symptoms may vary depending on the severity of the condition. Some common symptoms of pneumothorax are:

  • Sudden, sharp chest pain on the affected side that worsens with breathing or coughing
  • Shortness of breath
  • Rapid heart rate or palpitations
  • Bluish tint to the skin, lips, or nails (cyanosis) in severe cases
  • Dry cough or mild fever in some cases
  • Anxiety 
  • Fatigue 
  • Low blood pressure 

In certain cases, a small pneumothorax may not cause any noticeable symptoms and might resolve on its own. However, a larger pneumothorax is a clinical emergency and needs prompt medical attention. If you are experiencing any of the above symptoms, mainly sudden chest pain or difficulty breathing, make sure to seek medical attention immediately.

What are the pneumothorax causes?

There are several potential pneumothorax causes which include:

  • Trauma: Pneumothorax can occur as an outcome of blunt or penetrating chest trauma, like a rib fracture or a puncture wound.
  • Lung Disease: Certain lung diseases, such as chronic obstructive pulmonary disease (COPD), emphysema, and cystic fibrosis, can enhance the risk of developing pneumothorax.
  • Mechanical Ventilation: It can also occur as a complication of mechanical ventilation, which is used to support patients who are unable to breathe on their own.
  • Spontaneous Pneumothorax: In certain cases, pneumothorax can occur spontaneously, without any apparent cause.
  • Medical Procedures: Certain medical procedures, such as a lung biopsy or thoracentesis, which involves removing fluid or air from the pleural space, can also increase the risk of pneumothorax.
  • Rare Causes: Rarely, other factors like connective tissue disorders, Marfan syndrome, tuberculosis, histoplasmosis, sarcoidosis, and lung cancer may cause pneumothorax.
  • Medical conditions: It can also occur due to certain medical conditions such as asthma, pneumonia, lung cancer, Marfan syndrome, chest endometriosis, tuberculosis, acute respiratory distress syndrome, cystic fibrosis, emphysema, and collagen vascular disease. 
  • Lifestyle factors: There are various lifestyle factors that might cause this condition such as drug abuse, scuba, deep sea diving, flying involving drastic air changes in pressure, etc.

How is pneumothorax diagnosed?

Diagnosis of pneumothorax involves a combination of clinical assessment, physical examination, and imaging tests. Some common tests for diagnosing pneumothorax are:

  • Chest X-ray: A chest X-ray is usually the first imaging test done to diagnose pneumothorax. It allows the doctor to view air in the pleural cavity and the lung collapse extent. However, small pneumothoraces won't be visible on this test.
  • CT scan: A CT scan helps in providing more detailed chest images, permitting doctors to better identify small pneumothoraces and evaluate the lung collapse severity.
  • Ultrasound: Ultrasound is used to diagnose pneumothorax and guide treatment, mainly in cases where a chest tube insertion is required to remove the air.
  • Arterial blood gas analysis: This test helps in measuring the oxygen and carbon dioxide levels in the blood, and assists to determine the extent of the pneumothorax and the requirement for oxygen therapy.
  • Physical examination: A physical examination, including listening to the chest with a stethoscope, helps in identifying characteristic signs of pneumothorax, like reduced breath sounds on the affected side and a hyper resonant percussion note.

What are the options for pneumothorax treatment?

Pneumothorax, an accumulation of air in the space between the lung and the chest wall, can be treated in various ways depending on the extent of the condition. Below are some options for pneumothorax treatment:

  • Observation: Small pneumothorax cases resolve on their own with rest and observation. In certain cases, the doctor recommends periodic imaging to assess the condition.
  • Oxygen therapy: In certain cases, providing oxygen through a nasal cannula or face mask helps the lung to reabsorb the air that has leaked out.
  • Needle aspiration: In this procedure, the doctor inserts a needle through the chest wall for removing the excess air accumulated in the pleural space.
  • Chest tube insertion: A chest tube is a flexible tube that is inserted through the chest wall and into the pleural space and is used for draining air and fluid. It is performed under local anesthesia and may need hospitalization.
  • Surgery: Surgery is recommended in cases where other treatment options have failed to repair the damaged lung and prevent future episodes of pneumothorax. The most common surgical procedure for pneumothorax is called a thoracotomy. It is performed by making an incision in the chest wall to access the pleural space.

Conclusion

In conclusion, pneumothorax is a potentially serious medical condition that requires prompt diagnosis and appropriate treatment to prevent complications and promote recovery. If you suspect you or someone you know may be experiencing pneumothorax, seek medical attention immediately. You can consult one of the best pulmonologists in Jaipur at Rukmani Birla Hospital. With the assistance of its most highly talented and expert healthcare professionals, you can find the best diagnosis and treatment depending on your symptoms and the extent of the condition.

FAQs

Why does a pneumothorax cause the lung to collapse?

A pneumothorax occurs when air leaks into the pleural space, the area between the lung and the chest wall that is usually filled with a small amount of pleural fluid. When air accumulates in the pleural space, it creates pressure on the lung, which can cause it to collapse.

How does mechanical ventilation cause pneumothorax?

Mechanical ventilation can increase the risk of developing a pneumothorax, which is the presence of air in the pleural space that can cause the lung to collapse. There are several ways in which mechanical ventilation can lead to a pneumothorax such as barotrauma, trauma from the ventilation equipment, and lung disease. To minimize the risk of pneumothorax during mechanical ventilation, healthcare providers typically use lower-pressure settings and closely monitor patients for signs of lung damage or air leakage.

How to describe pneumothorax on chest X-ray?

A pneumothorax can often be seen on a chest X-ray, and there are several characteristic features that can be used to describe it such as air in the pleural space, lung collapse, pleural line, and deep sulcus sign.