Pneumothorax is a condition in which air collects in the space between the lungs and the chest wall. This air pocket puts pressure on the lung and can collapse a portion of the lung.
The chest cavity is normally a sealed chamber. Air can leak into the chamber through damaged lung tissue, the chest wall, or the diaphragm (a muscle that separates the abdominal and chest cavity). The air can eventually become large enough to collapse a section of lung.
Pneumothorax may be named according to its cause or how it acts, for example:
Primary spontaneous pneumothorax is more common in tall, thin young men, generally from teenagers up to the age of 30. Factors that may increase your chance of primary spontaneous pneumothorax may include:
Weakened lung tissue increases your risk of secondary spontaneous pneumothorax. Conditions that can cause weak lung tissue include:
Factors that may increase your chance of tension pneumothorax include:
Pneumothorax may not cause symptoms if it is small. Symptoms include:
Those with lung disease should be aware of the symptoms associated with pneumothorax. Get help as soon as symptoms arise.
You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor may be able to hear reduced or absent breath sounds on the affected side. The level of oxygen in your blood may be monitored with pulse oximetry.
Images of your chest cavity, including your heart and lungs, will need to be taken.
A small pneumothorax may resolve on its own or with oxygen therapy and observation. A larger pneumothorax and tension pneumothorax always requires treatment. Treatment focuses on providing oxygen and removing the air from the space so the lung can again expand to its full capacity.
Treatment may also be needed for health conditions that are causing the pneumothorax.
Oxygen is given for support, but may increase rate of resolution. It is given for any pneumothorax needed a procedure.
A needle may be inserted into the affected area. The excess air can be pulled out of the chest cavity through the needle. This will be done urgently for a tension pneumothorax.
Sometimes a chest tube will be placed in the chest. This tube will allow air to drain until it can be confirmed that the lung has fully expanded. It usually needed for large or symptomatic pneumothorax before or after needle aspiration.
The tube may be needed for several days for full expansion to occur.
An agent is put into the space between the chest and lung so they will stick together.
This may be needed if healing is not complete with other treatments and surgery is not wanted.
Surgery may be necessary for persistent air leaks or to prevent recurrence of some pneumothorax. Surgery may include:
Follow-up is an important part of any pneumothorax treatment plan. More than half of people with a pneumothorax have a recurrence.
Prevention will depend on the cause. If you smoke, talk with your doctor about how you can quit.
Other steps to help reduce your risk include:
American College of Chest Physicians
American Thoracic Society
The Canadian Lung Association
Catamenial pnuemothorax. National Organization for Rare Disorders website. Available at: http://www.rarediseases.org/rare-disease-information/rare-diseases/byID/1227/printFullReport. Updated February 14 2012. Accessed August 24, 2017.
Pneumothorax. Merck Manual website, Professional Version. Available at: http://www.merckmanuals.com/professional/pulmonary-disorders/mediastinal-and-pleural-disorders/pneumothorax. Updated September 2014. Accessed August 24, 2017.
Pneumothorax - emergency management. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T913035/Pneumothorax-emergency-management. Accessed August 24, 2017.
Spontaneous pneumothorax in children. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T306335/Spontaneous-pneumothorax-in-children. Updated January 11, 2016. Accessed August 24, 2017.
Spontaneous pneumothorax in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114714/Spontaneous-pneumothorax-in-adults. Updated June 19, 2017. Accessed August 24, 2017.
Tension pneumothorax. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115634/Tension-pneumothorax. Updated January 151, 201t. Accessed August 24, 2017.
Last reviewed September 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.