What is Pneumothorax?

J.M. Willhite

Pneumothorax is the formal medical term for a collapsed lung. Sometimes known as spontaneous pneumothorax, a lung collapses when air accumulates in the space that surrounds it. Treatment for this potentially serious condition may include the administration of oxygen and the artificial re-inflation of the lung.

A stethoscope can be used to identify a pneumothorax.
A stethoscope can be used to identify a pneumothorax.

There are several situations that may contribute to the occurrence of a lung collapse. Injuries including chest trauma and rib fractures may lead to lung collapse. Certain habits and activities may result in lung collapse, including smoking, scuba diving, and flying. Individuals who have been diagnosed with certain lung disorders, such as asthma, tuberculosis, and cystic fibrosis, may also experience lung collapse.

Chest x-rays are used to confirm a diagnosis of pneumothorax.
Chest x-rays are used to confirm a diagnosis of pneumothorax.

When a lung collapses without any known cause, it may be referred to as a spontaneous pneumothorax. In some cases, a small air pocket within the lung tissue itself, known as a bleb, may rupture. The air that leaks from this ruptured sac may then leak into the cavity surrounding the lung. The accumulation of leaked air, over a period of time, may lead to the partial or complete collapse of the lung depending on the amount of air pressing against it.

Individuals with a pneumothorax may gradually become symptomatic. Common signs associated with a collapsed lung include shortness of breath and intense chest pain that accompanies coughing or a deep breath. Some individuals may become easily fatigued with little exertion or develop an accelerated heart rate. Additional signs may include a bluish tinge to the skin due to inadequate oxygen, low blood pressure, and a feeling of tightness in the chest.

A pneumothorax is usually identifiable through a stethoscope because there may be weakened or non-existent breath sounds. Diagnostic testing may be conducted to confirm that a pneumothorax has occurred and evaluate its severity. A chest X-ray may be performed to determine if there is any air accumulating in the cavity surrounding the affected lung. In some cases, an arterial blood gas analysis (ABG) may be conducted to measure carbon dioxide and oxygen levels in the blood.

Treatment for a collapsed lung is dependent on the extent of the collapse and the overall health of the individual. If the collapse is small, it may be monitored and left to heal independently. Individuals whose lung collapse is considered to be mild may be given supplemental oxygen and instructed to rest. Air that has accumulated in the space surrounding the lung may be removed with a needle to alleviate any external pressure.

Those who experience a near complete or complete lung collapse may require the placement of a chest tube to drain escaping air. Positioned between the ribs near the lungs, a chest tube may remain in place for several days, requiring extended hospitalization. Supplemental oxygen may be administered while the chest tube fosters the re-expansion of the affected lung. Severe cases of a pneumothorax may necessitate lung surgery to correct the collapse and prevent a future recurrence.

An individual’s prognosis is dependent on the extent of the lung collapse and its cause. Those with a history of pneumothorax or who smoke are at an increased risk for future lung collapse. Complications associated with a lung collapse include recurrent collapse and shock.

Scuba divers are at risk of pneumothorax.
Scuba divers are at risk of pneumothorax.

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