Make an Appointment
Talk to DoctorOverview
Pneumothorax, often referred to as a collapsed lung, happens when air leaks into the space between the lung and chest wall, applying pressure on the lung. This condition can cause the lung to collapse partially or entirely. While minor cases may resolve independently, severe instances can pose a significant risk to life. Pneumothorax can develop spontaneously or result from various causes such as existing health issues, trauma, or medical interventions. Symptoms including abrupt chest pain, breathing difficulties, or a bluish tint to the skin should prompt immediate medical intervention. Treatment typically involves the insertion of a chest tube or needle between the ribs to remove the excess air.
Symptoms
The signs and symptoms of pneumothorax can vary based on the extent to which the lung has collapsed. It may include:
- Dyspnea, or difficulty breathing
- Abrupt onset of chest discomfort
- Chest pain on one side, especially when breathing
- Elevated heart rate
- Cough
- Rapid breathing
- Cyanosis, or lips, nails, or skin that is bluish
- Fatigue
If you notice any of the following signs or symptoms, it’s important to reach out to a healthcare professional for an accurate diagnosis and appropriate treatment. Should you experience severe chest pain or difficulty breathing that worsens over time, it’s critical to seek immediate medical attention.
For those with a previous history of a collapsed lung (pneumothorax), it’s vital to promptly seek medical help if symptoms reemerge or deteriorate, indicating a potential for recurrence and increased risk.
Causes
There are several factors that can cause pneumothorax, such as:
- Injuries: Injuries such as blunt force trauma, gunshot or stab wounds can result in pneumothorax. Certain injuries may be unintentionally sustained during medical procedures that require the introduction of a needle into the chest, while other injuries may result from physical assaults or vehicle accidents. Lung collapse can result from any blunt or piercing injury to the chest.
- Mechanical ventilation: This is a type of life support that assists individuals in breathing when they are unable to do so independently. The chest’s air pressure may become unbalanced as a result of the ventilator which can lead to a total lung collapse. A severe kind of pneumothorax typically occur in these cases.
- Lung disease: Conditions, like lymphangioleiomyomatosis and Birt-Hogg-Dube syndrome, can create fragile air sacs in the lungs that can burst, leading to pneumothorax. Various diseases like COPD, cystic fibrosis, lung cancer, or pneumonia can cause lung tissue damage leading to a higher risk of a collapsed lung.
- Air blisters that ruptured: Air may seep into the area around the lungs when air blisters or blebs burst. Blebs, or tiny air sacs can form on the surface of the lungs.
Risk factors
Several factors may contribute to one’s risk of developing pneumothorax, such as:
- Age: People between the ages of 20 and 40 are most prone to experience a type of pneumothorax particularly if they are extremely tall and underweight.
- Gender: Pneumothoraxes are often much more common in men than in women.
- Genetics: Individuals with a higher risk of experiencing a collapsed lung, or pneumothorax, include those with a family history of the condition. Some types of the condition runs in families.
- Smoking: Even in the absence of emphysema, the risk rises with the amount of time and cigarettes smoked.
- History of pneumothorax: A person’s risk of experiencing another pneumothorax is elevated after one.
- Underlying conditions or treatment: Those diagnosed with Marfan syndrome, endometriosis, certain lung disease, and under mechanical ventilation has an increased risk of acquiring pneumothorax.
Diagnosis
Healthcare providers typically diagnose a collapsed lung through various methods, starting with listening to the lungs and employing imaging techniques. These techniques include chest X-rays, computed tomography (CT) scans, and lung ultrasounds. Additionally, an arterial blood gas test might be conducted to assess the oxygen and carbon dioxide levels in your blood.
During the diagnosis process, your healthcare provider will inquire about any history of lung disease and conduct a physical examination. Certain conditions, such as tension pneumothorax, are primarily diagnosed based on the patient’s symptoms.
Treatment
Treatment for pneumothorax varies based on factors such as its cause, size, severity, and patient’s overall health may also be considered. The main goal is to relieve pressure on the lung so it can expand again. Preventing future occurrences might also be a goal depending on the cause.
Common treatment options include:
- Observation: Monitoring may take several weeks. This is often recommended in cases of minor pneumothoraxes. The healthcare provider may utilize regular chest X-rays to track progress until the excess air dissipates and the lung fully re-expands.
- Treatment procedures: Either a needle or a chest tube may be utilized to extract the surplus air in more severe cases.
- Thoracentesis or needle aspiration: During the procedure a needle is inserted between the ribs into the space around the collapsed lung, then a syringe is attached to drain out the excess air. Sometimes a small tube is left in place for a few hours to make sure the lung fully expands again and to prevent the problem from happening again. This helps relieve pressure on the chest, making it easier to breathe.
- Chest tube insertion: This is often recommended in larger pneumothorax. A flexible tube goes into the space filled with air. It is connected to a special device, a one-way valve, that keeps pulling air out of the chest until the lung gets bigger and better. The chest tube may remain in position for a period ranging from a few days to an extended duration.
- Nonsurgical methods: If specialized procedures fail to resolve the issue, nonsurgical treatments may be suggested:
- Placing a one-way valve: This is to allow the lung to re-expand and the leak to heal. This is done using a thin tube called a bronchoscope that is inserted through the throat into the lungs.
- Creating an autologous blood patch, or a fibrinous patch: Blood is drawn and placed in the chest tube via the arm. The blood plugs the air leak in the lung by forming into this patch.
- Irritating the tissues around the lung: This will promote adhesion and seal any leaks. This can be accomplished either through the chest tube or during a surgical procedure.
- Surgery: Surgery may be necessary for individuals with a punctured lung that does not respond to other treatments or if they experience persistent air leakage from the chest tube, fail to expand the lung despite chest tube insertion, suffer from recurrent collapsed lungs, have pneumothorax in both lungs, and sustain traumatic lung injuries.
The healthcare provider will locate the site of the leak or ruptured air blister and seal it off. In rare instances, a larger incision between the ribs might be required to access multiple or larger leaks more effectively. In most cases, small incisions are done through specialized instruments including a fiber-optic camera.
- Ongoing care: In most cases, a punctured lung can heal within a span of a few days to two weeks. During this time, the body gradually reabsorbs the excess air surrounding the lung, allowing it to reinflate naturally. After the pneumothorax heals, one might have to avoid certain activities that strain the lungs, like flying, scuba diving, or playing wind instruments for a while. Attending to all follow-up appointments is also a must to monitor recovery.
