A pneumothorax (noo-moe-THOR-aks) is a collapsed lung. This air pushes to the outside of your lungs and collapses them. A pneumothorax can be a complete collapse of a lung or a collapse of only a portion of a lung. A pneumothorax can be caused by blunt or penetrating chest trauma, certain medical procedures, or damage from underlying lung disease. Or it may occur without any apparent reason. Symptoms usually include sudden pain in the chest and shortness of breath. In some cases, a collapsed lung can be fatal. A collapsed lung occurs when air moves into the chest cavity (outside the lungs) and creates pressure against the lungs. Also known as pneumothorax, a collapsed lung is a rare condition that can cause chest pain and difficulty breathing. A collapsed lung requires immediate medical attention.
Different types of pneumothorax
There are five main types of the collapsed lung:
- Primary spontaneous pneumothorax: A collapsed lung sometimes occurs in people who do not have other lung problems. This can be caused by abnormal air sacs in the lungs that rupture and release air.
- Secondary spontaneous pneumothorax: Several lung diseases can cause a collapsed lung. These may include chronic obstructive pulmonary disease (COPD), cystic fibrosis, and asthma.
- Trauma-related pneumothorax: Injury to the chest can cause a collapsed lung. Some people experience a collapsed lung from a broken rib, blunt force trauma to the chest, or a knife or gunshot wound.
- Iatrogenic pneumothorax: After certain medical procedures such as a lung biopsy or insertion of a central venous line, some people may develop complications that include a pneumothorax.
- Catamenial pneumothorax: This rare condition affects those women who have endometriosis. Endometrial tissue lines the uterus. With endometriosis, the uterus grows outside the uterus and attaches to an area inside the chest. Endometrial tissue forms cysts that bleed into the pleural space, causing the lungs to collapse.
What causes a collapsed lung?
There are three main causes of pneumothorax: medical conditions, injuries, and lifestyle factors.
Medical conditions that can cause a collapsed lung to include:
- Asthma
- Pneumonia.
- Chronic obstructive pulmonary disease (COPD).
- Collagen vascular disease.
- Initial status.
- Emphysema
- Endometriosis in the breast.
- Idiopathic pulmonary fibrosis.
- lung cancer.
- Lymphangioleiomyomatosis.
- Marfan syndrome.
- Tuberculosis
- Acute respiratory distress syndrome (ARDS) is a condition caused by pneumonia, coronavirus, and other diseases.
Injuries that can cause a collapsed lung include:
- Blunt force trauma.
- Specific types of ventilation or changes in ventilation.
- bullet wound
- Lung puncture during a medical procedure, such as a biopsy or nerve block.
- Stab wound.
Lifestyle factors associated with collapsed lungs include:
- Drug use especially inhaled drugs.
- Flight involves drastic changes in air pressure.
- Scuba or deep sea diving.
- smoking
People with certain other risk factors may be more likely to develop lung collapse. These are:
- Family history of pneumothorax.
- pregnancy
- Tall, slim body type.
Symptoms of Pneumothorax
Symptoms can range from mild to severe. If your case is mild, you may not see a problem. That’s why it’s important to tell your doctor what’s going on. Common symptoms include:
- Blue skin
- Chest pain, cramping, or tightness
- Cough
- Fatigue
- Breathing fast
- Fast heartbeat
- shortness of breath
Diagnosis of pneumothorax
Your health care provider will ask about your history of lung disease and perform a physical exam. They can also measure the level of certain gases in your blood. To measure gases such as oxygen and carbon dioxide, a technician collects a blood sample and analyzes it in a laboratory. Medical imaging is the most common way to diagnose a collapsed lung. Usually, you will have a chest X-ray. But you may have a Computed Tomography scan
or ultrasound.
Treatment of Pneumothorax
The goal of treating a pneumothorax is to relieve pressure on your lungs, which can cause them to expand again. Depending on the cause of the pneumothorax, another goal may be to prevent a recurrence. How to achieve these goals depends on the severity of the lung collapse and sometimes your overall health. You might receive supplemental oxygen therapy to speed up air reabsorption and lung expansion.
Observation
If only a small part of your lung has 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 should not expand again. This may take several weeks.
Needle aspiration or chest tube insertion
If a large part of your lung has collapsed, a needle or chest tube will likely be used to remove the excess air.
- The desire for a needle. A hollow needle with a small flexible tube (catheter) is inserted into the air-filled space between the ribs to press on the collapsed lung. Then the doctor removes the needle, attaches the syringe to the catheter, and expels the excess air. The catheter may be left in place for a few hours to re-expand the lungs and ensure that the pneumothorax does not reoccur.
- 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 your lungs re-expand and heals.
Non-surgical repair
If a chest tube does not re-expand your lungs, non-surgical options to close the air leak may include:
- Using a substance to irritate the tissues around the lungs so they stick together and stop any leakage. This can be done through a chest tube, but it can also be done during surgery.
- Draw blood from your arm and put it into a chest tube. The blood forms a fibrous patch over the lung (autologous blood patch), sealing the air leak.
- Passing a thin tube (bronchoscope) down your throat and into your lungs and inserting a one-way valve to see your lungs and airways. The valve allows the lungs to re-expand and repair the air leak.
Surgery
Sometimes surgery may be necessary to stop the air leak. In most cases, surgery can be performed through a small incision, using a small fiber optic camera and narrow, long surgical tools. The surgeon will look for a leaky site or ruptured air sac and close it. Rarely, the surgeon will need to make a large incision between the ribs to gain better access to multiple or large air leaks.