Pneumothorax is a collection of air or gas in the pleural space of the lung, causing the lung to collapse. Pneumothorax may be the result of an open chest wound that permits the entrance of air, the rupture of an emphysematous vesicle on the surface of the lung, a severe bout of coughing, or it may occur spontaneously without evident cause.
The major types of pneumothorax are:
Open pneumothorax results when a penetrating chest wound enables air to rush in and cause the lungs to collapse.
Closed pneumothorax results when the chest wall is punctured or air leaks from a ruptured bronchus (or a perforated esophagus) and eventually ruptures into the pleural space.
Spontaneous pneumothorax occurs in a previously healthy individual with no prior trauma. This is thought to be due to rupture of a bleb (a blister containing air) on the surface of the lung. This spontaneous pneumothorax is most frequent in people under the age of 40.
Pulmonary barotrauma occurs when a patient whose lung function is being maintained mechanically may have air forced into the lungs, which may rupture the pleural space.
Other things can cause pneumothorax. Air can enter the mediastinum (the space in the center of the chest between the lungs), especially during an asthmatic attack, and then rupture into the pleural space, causing a pneumothorax. When a lung biopsy specimen is taken at the time of bronchoscopy or during thoracentesis (removal of fluid from the pleural space), the pleura lining the lung may be penetrated, causing a leak of air which may then cause a pneumothorax.
There may be no symptoms if the pneumothorax is small (a small amount of air in the pleural space) or there may be shortness of breath if a large amount of air is in that space. If a physician suspects a pneumothorax, a chest x-ray may be taken to confirm the diagnosis and to determine the amount of air present.
If the lung is less than 20 to 25 percent collapsed, the physician may choose to watch the progress by a series of chest x-rays until the air is completely absorbed or the lung completely re-expands.
If collapse of the lung exceeds 25 percent or if you are short of breath at rest, the physician may recommend removing the air through your chest wall. This can be done with a needle, but is better performed by inserting a tube and applying constant suction for 24 hours or more. The latter procedure also helps to prevent recurrence of pneumothorax.
Pneumothorax in the Newborn
Air leaks from the lungs into other parts of the chest cavity can occur in newborns, and it is a potentially serious problem. Small air leaks can occur in 1 to 2 percent of all births. Babies are normally born with collapsed lungs, and considerable pressure is generated as the newborn’s body works to inflate them with the first few breaths. There is no problem whatsoever for 98 percent of all newborns, but in some babies, the lungs do not open completely at once, and the strong pressures generated to inflate the lung may cause small ruptures in the alveoli (the smallest, most plentiful breathing sacs). The leaked air may be removed from the chest cavity by the attending physician. Continuous removal of leaked air is necessary until the ruptures heal.
How much air is present in the lungs?
What percentage of the lung has collapsed?
What type of treatment will you be recommending? Will treatment involve being hooked up to a machine and how often?
Is the treatment painful?
How long will full recovery take?
What type of symptoms should be reported?
If the lungs weaken, will they be susceptible to another type of pneumothorax?
Will you be recommending any medication? Are there any side effects?