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 underlying lung disease. Or, it can happen without an 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, the treatment of 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 the symptoms may depend on how much the lung is collapsed.
When should you see a doctor?
The symptoms of a pneumothorax can be caused by a variety of health problems, some of which can be life-threatening, so seek medical attention. If chest pain is severe or breathing becomes increasingly difficult, seek emergency care immediately.
Diagnosis
The goal of treating a pneumothorax is to relieve 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 collapsed lung and sometimes your general health.
Treatment options may include observation, needle aspiration, chest tube insertion, nonsurgical repair, or surgery. You may receive supplemental oxygen therapy to speed 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 can take several weeks.
Needle aspiration or chest tube insertion
If a larger area of your lung has collapsed, a needle or chest tube may be used to remove excess air. needle aspiration. A hollow needle with a small flexible tube (catheter) is inserted between the ribs to reach the air-filled space that is pressing on the collapsed lung. The doctor removes the needle, connects a syringe to the catheter, and removes the excess air. The catheter may be left in for a few hours to make sure the lung expands again and the pneumothorax does not recur. Chest tube insertion. A flexible chest tube is inserted into the air-filled space and may be connected to a one-way valve device that continuously removes air from the chest cavity until the lung re-expands and heals.
Non-surgical repair
If the chest tube fails to expand the lung, non-surgical options to close the air leak may include: Using a substance to irritate the tissues around the lung so that it sticks and seals any leaks. This can be done through the chest tube, or it could also be done during surgery. Draw blood from the arm and place it in the chest tube. The blood creates a fibrinous patch in the lung (autologous blood patch), which seals the air leak. Passing a thin tube (bronchoscope) down the throat into the lungs to look at the lungs and airways and place a one-way valve. The valve allows the lung to re-expand and the air leak to heal.
Surgery
Sometimes surgery may be needed to close the air leak. In most cases, surgery can be done through small incisions, with a small fiberoptic camera and narrow, long-handled surgical tools. The surgeon will find the leaking area or ruptured air bleb and close it.
On rare occasions, the surgeon will need to make a larger incision between the ribs in order to better access larger air leaks or multiple leaks.
