Pneumothorax

Definition

Pneumothorax is the collection of air or gas in the space around the lungs.

Alternative Names

Air around the lung; Air outside the lung

Causes, incidence, and risk factors

Pneumothorax may result from chest trauma, excess pressure on the lungs, or a lung disease such as COPD, asthma, cystic fibrosis, tuberculosis, or whooping cough. In some cases, the cause is unclear.

See also:

• Spontaneous pneumothorax
• Tension pneumothorax
• Traumatic pneumothorax

Symptoms

• Sudden sharp chest pain, made worse by a deep breath or a cough
• Shortness of breath
• Chest tightness
• Easy fatigue
• Rapid heart rate
• Bluish color of the skin caused by lack of oxygen

Note: Symptoms may begin during rest or sleep.

Other symptoms that can occur with this disease:

• Nasal flaring
• Anxiety, stress, and tension
• Low blood pressure (hypotension)

Signs and tests

There are decreased or no breath sounds on the affected side when heard through a stethoscope.

Tests include:

• Chest x-ray to tell whether there is air outside the lung
• Arterial blood gases

Treatment

Small pneumothoraces may go away on their own.

For larger pneumothoraces, the air must be removed from around the lung. A chest tube placed between the ribs into the space around the lungs helps drain the air and allows the lung to re-expand. The chest tube can be left in place for several days. The person must stay in the hospital while the chest tube is in place.

Some people need extra oxygen to help air around the lung be reabsorbed more quickly. Surgery may be needed to prevent future episodes.

Expectations (prognosis)

Up to 50% of patients who have a pneumothorax will have another, but there are no long-term complications after successful treatment.

Complications

• Recurrent pneumothorax
• Tension pneumothorax with shock

Calling your health care provider

Call your health care provider if you have symptoms of pneumothorax, especially if you have had this condition before.

Prevention

There is no known way to prevent pneumothorax, but you can decrease your risk by not smoking.

References

Baumann MH, Strange C, Heffner JE, Light R, Kirby TJ, Klein J, et al. Management of spontaneous pneumothorax. Chest. February 2001;199:590-602.

Murray J, Nadel J. Textbook of Respiratory Medicine. 3rd ed. Philadelphia, Pa: WB Saunders; 2000.

Marx J. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.