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. The pressure can collapse a part of the lung.
The chest cavity should be a sealed chamber. Air can leak into the chamber if there is damage to lung tissue, the chest wall or the diaphragm. The diaphragm is a large muscle that sits under the lungs. It separates the abdomen and chest cavity.
The air creates a pocket in the chest cavity. When it becomes large enough it will collapse a section of lung. Some may only affect a small area, others may be life-threatening.
Causes may vary based on the type of pneumothorax, for example:
Primary spontaneous pneumothorax is more common in:
Factors that may increase your chance of primary spontaneous pneumothorax may include:
Conditions that increases your risk of secondary spontaneous pneumothorax include:
Factors that may increase your chance of tension pneumothorax include:
Pneumothorax may not cause symptoms if it is small. If they do occur, symptoms include:
Those with lung disease should be aware of these symptoms. 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, heart, and lungs, will be needed. Your doctor may order one or more of the following:
Treatment will depend on how much of the lung is involved. The goals of treatment are to remove the excess air and let the lung fully expand again.
Oxygen may be given if you are having trouble breathing. It may also help speed up removal of air.
Treatment options include:
If only a small area of the lung is involved, it may resolve on its own. The progress will be monitored by the doctor. X-rays will show when the lung has fully expanded again.
The excess air may need to be removed. It may be needed for a large pneumothorax. This will be done urgently for a tension pneumothorax.
The excess air may be pulled out of the chest with a needle. Once the air is removed, the needle can be removed.
A chest tube may be needed for large collapse. It may also be needed for a pneumothorax that has problems before or after needle procedure. The tube will be placed through the chest wall. It will stay in place to let air drain until the lung has fully expanded. The tube may be needed for several days.
This method may be needed if the area has not fully healed and surgery is not wanted. An agent is put into the space between the chest wall and the lung. It will help the sides stick together so that more air cannot enter.
Surgery may be needed if air leaks continue. It may also be done to stop some types of pneumothorax from happening again. Surgery may include:
Follow-up is an important part of any pneumothorax treatment plan. More than half of people with a pneumothorax will have another one.
Prevention will depend on the cause. Steps to help reduce your risk of some pneumothoraxes 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.