MedlinePlus Medical Encyclopedia: Pneumothorax

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Pneumothorax

Contents of this page:
Illustrations Alternative names Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Expectations (prognosis) Complications Calling your health care provider Prevention

Illustrations

Lungs

Aortic rupture, chest X-ray

Pneumothorax - chest X-ray

Chest tube insertion - series

Respiratory system

Alternative names Return to top

Air around the lung; Air outside the lung

Definition Return to top

A pneumothorax is collection of air or gas in the pleural space (the space surrounding the lungs). See also Spontaneous pneumothorax, traumatic pneumothorax, and tension pneumothorax.

Causes, incidence, and risk factors Return to top

There are several types of pneumothorax, which are classified by cause.

Spontaneous pneumothorax is the occurrence of pneumothorax without a clear cause. Primary spontaneous pneumothorax occurs when there is no known underlying lung disease. It is thought to be caused by the rupture of a small, air-filled sac in the lung called a bleb or a bulla. The disease affects tall, thin men between 20 and 40 years old most frequently. Cigarette smoking and family history are contributing factors.

Secondary spontaneous pneumothorax is a complication of underlying pulmonary (lung) disease, such as COPD, asthma, cystic fibrosis, tuberculosis, and whooping cough.

Traumatic pneumothorax results from a traumatic injury to the chest. The trauma may be penetrating (stab wound, gunshot) or blunt (blow from a motor vehicle accident). Pneumothorax may complicate certain medical procedures.

Tension pneumothorax is caused when excessive pressure builds up around the lung, forcing it to collapse. The excessive pressure can also prevent the heart from pumping blood effectively, leading to shock.

Symptoms Return to top

sudden sharp chest pain, especially made worse by a deep breath or a cough
shortness of breath
chest tightness
easy fatigue
rapid heart rate
bluish color of the skin caused by lack of oxygen

Note: Symptoms may begin during rest or sleep.

Additional symptoms that may be associated with this disease:

Signs and tests Return to top

Stethoscope examination of the chest reveals decreased or absent breath sounds on the affected side.

Tests include:

chest X-ray to determine presence of air outside the lung
arterial blood gases

Treatment Return to top

The objective of treatment is to remove the air from the pleural space, allowing the lung to re-expand. Small pneumothoraces may resolve on their own.

The placement of a chest tube (chest tube insertion) between the ribs into the pleural space allows the evacuation of air from the pleural space. With the chest tube left in place, the lung may take several days to re-expand. Hospitalization is required for proper care of the chest tube.

Supplemental oxygen may be needed to help air around the lung be reabsorbed more quickly.

Surgery may be needed to prevent recurrent episodes.

Expectations (prognosis) Return to top

Up to 50% of patients with pneumothorax experience recurrence, but there are no long-term complications following successful therapy.

Complications Return to top

recurrent pneumothorax
tension pneumothorax with shock

Calling your health care provider Return to top

Call your health care provider if symptoms of pneumothorax develop; especially if you have previously experienced this condition.

Prevention Return to top

There is no known prevention, other than to decrease risk by stopping smoking.

Update Date: 10/22/2003

Updated by: Allen J. Blaivas, D.O., Division of Pulmonary, Critical Care, and Sleep Medicine, University Hospital, Newark, NJ. Review provided by VeriMed Healthcare Network.

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