A pneumothorax is air in the space between the lungs and the chest wall. This air bubble puts can push down on the lungs. A small amount of air may not cause symptoms. More air will make it hard to breathe and collapse part of the lung.
The air leak happens because of damage to the chest wall, lungs, or muscle under the lungs. Types of pneumothorax are based on causes:
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Primary spontaneous pneumothorax is more common in tall, thin, young men.
The risk of primary spontaneous pneumothorax is higher with:
The risk of secondary spontaneous pneumothorax is higher with:
The risk of tension pneumothorax is higher with:
Pneumothorax may not cause symptoms if it is small. Larger pneumothorax can cause:
Those with lung disease should be aware of these symptoms. Get help as soon as symptoms arise.
You will be asked about your symptoms and past health. A physical exam will be done. The doctor will listen to breath sounds. A diagnosis may be made based on sounds and symptoms.
Images of the chest will be done. It will show how large the air leak is. Image tests may include:
Treatment will depend on the size of the pneumothorax. A small injury may heal on its own. Tests may be done to make sure the area has healed.
Larger problems will need care. The goal of treatment is to take out the extra air and let the lung open again.
Air may be pulled out of the chest with a needle. It will be placed through the chest wall. The needle can be removed once the air is out.
A chest tube may be needed for large lung collapse. The tube is placed through the chest wall. It will stay in place until the lung has fully opened. The tube may be needed for several days.
Surgery may be needed if air leaks continue. It may also be done if the pneumothorax keeps happening. Surgery may include:
Follow-up is an important part of the treatment plan. More than half of people with a pneumothorax will have another one.
Prevention will depend on the cause. Steps to help reduce your risk of some pneumothorax include:
American College of Chest Physicians
American Thoracic Society
The Canadian Lung Association
Pneumothorax. Merck Manual website, Professional Version. Available at: http://www.merckmanuals.com/professional/pulmonary-disorders/mediastinal-and-pleural-disorders/pneumothorax. Updated October 2017. Accessed August 20, 2018.
Spontaneous pneumothorax in adults. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114714/Spontaneous-pneumothorax-in-adults. Updated August 13, 2018. Accessed August 20, 2018.
Tension pneumothorax. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115634/Tension-pneumothorax. Updated January 15, 2017. Accessed August 20, 2018.
Last reviewed September 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP