Pneumothorax: what are its symptoms, its causes and its treatment

A pneumothorax is a collapsed lung. A pneumothorax occurs when air leaks into the space between the lungs and the chest wall. The air presses on the outside of the lung and causes it to collapse. A pneumothorax can be a collapsed entire lung or a collapsed part of the lung.

A pneumothorax can be caused by a contusion or penetrating injury to the chest, certain medical procedures, or damage from an underlying lung disease. Or it can happen for no obvious reason. Symptoms usually include sudden chest pain and shortness of breath. On some occasions, a collapsed lung can be a life-threatening event.

In general, treatment for a pneumothorax involves inserting a needle or chest tube between the ribs to remove excess air. However, a small pneumothorax can heal on its own.

Symptoms

The main symptoms of a pneumothorax are sudden chest pain and shortness of breath. The severity of symptoms may depend on the degree of lung collapse.

When should you see a doctor?

Symptoms of a pneumothorax can be caused by a variety of health conditions, some of which can be life-threatening, so see a doctor. If chest pain is severe or breathing becomes increasingly difficult, seek emergency medical attention immediately.

Diagnostic

The goal of treating a pneumothorax is to release the pressure in the lung to allow it to expand again. Depending on the cause of the pneumothorax, a second goal may be to prevent recurrences. The methods for achieving these goals depend on the severity of the lung collapse and sometimes your overall health.

Treatment options may include observation, needle aspiration, chest tube insertion, nonsurgical repair, or surgery. You may receive supplemental oxygen therapy to speed up air reabsorption and lung expansion.

Observation

If you only have part of your lung collapsed, your doctor may simply monitor your condition with a series of chest X-rays until the excess air is completely absorbed and the lung expands again. This may take several weeks.

Needle aspiration or chest tube insertion

If more of your lung has collapsed, a needle or chest tube may be used to remove the excess air. needle puncture. A hollow needle with a small flexible tube (catheter) is inserted between the ribs to reach the air-filled space that presses on the collapsed lung. The doctor removes the needle, connects a syringe to the catheter, and removes excess air. The catheter can be left in place for a few hours to ensure that the lung expands again and the pneumothorax does not reoccur. Insertion of the pleural probe. A flexible chest tube is inserted into the air-filled space and can be connected to a one-way valve device that continuously removes air from the chest cavity until the lung expands again and heals.

Non-surgical repair

If the chest tube fails to expand the lung, non-surgical options for sealing the air leak may include: Using a substance to irritate the tissues around the lung so that it sticks together and seals any leaks. This can be done through the chest tube, or it can also be done during surgery. Draw blood from the arm and place it in the chest tube. The blood creates a fibrinous plaque in the lungs (autologous blood plaque) which seals the air leak. Pass a thin tube (bronchoscope) down the throat into the lungs to examine the lungs and airways and place a one-way valve. The valve allows the lung to expand again and the air leak to heal.

Surgery

Sometimes surgery may be needed to close the air leak. In most cases, surgery can be performed through small incisions, with a small fiber optic camera and narrow, long-handled surgical tools. The surgeon will find the leaking area or ruptured air bubble and close it.

On rare occasions, the surgeon will need to make a larger incision between the ribs to better access larger air leaks or multiple leaks.