Pronounced: Noom-oh-THOR-ax
Pneumothorax is a condition in which air or gas collects in the "pleural space" or "pleural cavity," which is the space between the lungs and the chest cavity. This can cause the lung to collapse.
Normally, the lungs sit next to the inner surface of the chest wall. Thin membranes called pleura cover both the lungs and the chest wall. A pneumothorax occurs when air either escapes the lung or leaks in through the chest wall and builds up in the pleural space between them. This build-up of air can result in the collapse of the affected lung.
There are different types of pneumothorax, and each one is defined by its cause.
Primary spontaneous pneumothorax occurs when there is no other underlying lung disease. It is often caused by the rupture of an air-filled sac in the lung, called a bleb or bulla.
Smoking is associated with a higher incidence of spontaneous pneumothorax.
Secondary spontaneous pneumothorax occurs as a complication of another lung disease. Lung diseases which are associated with the development of pneumothorax include:
Traumatic pneumothorax occurs as a result of a traumatic injury to the chest. The injury could be penetrating, such as a bullet or stab wound, or blunt, such as a blow to the chest or automobile accident. A traumatic pneumothorax can complicate other medical procedures that may be necessary following a traumatic injury.
Tension pneumothorax occurs when excessive pressure builds up around the lung and forces it to collapse. This pressure can also affect the heart’s ability to pump blood. For this reason, tension pneumothorax is considered the most serious type.
The following factors increase your chance of developing pneumothorax:
If you experience any of the symptoms listed below, do not assume it is due to pneumothorax. These symptoms are often caused by other, less serious health conditions. If you experience any of them, see your physician.
Symptoms of pneumothorax may occur while you are awake or while you are asleep. They can include:
Your doctor will ask about your symptoms and medical history, and perform a physical exam. He or she may notice that the affected side of your chest has reduced or absent breath sounds during the stethoscope examination. Other tests may be performed, such as:
Since the development of pneumothorax can be delayed in the case of traumatic pneumothorax, repeating x-rays the day after the injury may be needed.
While a small pneumothorax will usually resolve itself without intervention in a week or two, a larger pneumothorax often requires treatment. Oxygen is commonly administered.
Treatment focuses on removing the air from the pleural space so the lung can again expand to its full capacity. This can be accomplished by inserting a needle and syringe or inserting a chest tube.
Surgery to remove blebs or attach the lung permanently to the chest wall is sometimes needed to prevent recurrences.
Up to 50% of patients who experience pneumothorax have a recurrence, but there are no long-term consequences following treatment.
If you are diagnosed with pneumothorax, follow your doctor's instructions .
There is no known way to prevent pneumothorax. However, you can lower your risk of developing pneumothorax by:
RESOURCES:
American College of Chest Physicians
http://www.chestnet.org
American Thoracic Society
http://thoracic.org
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/index_e.html
The Canadian Lung Association
http://www.lung.ca
References:
Baumann MH. Management of spontaneous pneumothorax. Clin Chest Med . 2006; 27:369-81.
Currie GP, Alluri R, Christie GL, Legge JS: Pneumothorax: an update. Postgrad Med J . 2007;83:461-5.
Leigh-Smith S, Harris T. Tension pneumothorax-time for a re-think? Emerg Med J . 2005;22: 8-16.
Light RW. Disorders of the pleura, mediastinum, diaphragm, and chest wall. in: Kasper DL et al., eds. Harrison's Principles of Internal Medicine . 16th ed. New York: McGraw-Hill; 2005:1568.
Pneumothorax. The Merck Manual of Medical Information, Second Home Edition online. Available at: http://www.merck.com/mmhe/sec04/ch052/ch052d.html . Accessed November 9, 2005.
Sahn S, Hefner JE. Spontaneous pneumothorax. N Engl J Med . 2000;342:868-73.
Tschopp JM, Rami-Porta R, Noppen M, Astoul P: Management of spontaneous pneumothroax: state of the art. Eur Respir J . 2006;28:637-50.
Last reviewed September 2009 by Christine Colpitts, CRT, MA
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.
Copyright © 2007 EBSCO Publishing All rights reserved.