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.