Treatment of Pneumothorax

About the disease

Pneumothorax is the leakage of air in the area between the lungs and the chest wall. As a result, the lung collapses. It happens because the leaked air starts to push the outside wall of the lungs. In most cases only a part of the lung collapses. It is rare for the whole lung to collapse.

The most common cause of pneumothorax is injury to the chest wall. It can be either blunt or penetrating injury. Blunt chest injury can happen as a result of motor vehicle accident or severe fall. Penetrating injury can happen as a result of an assault. In some cases, pneumothorax develops as a result of previous surgery on the chest which led to leakage of the air. Some medical procedures include insertion of the needle into the chest. It is important to conduct such procedures with utmost care and attention not to cause the air leakage between the lung and the chest wall. It is important to be checked up regularly after the surgery to avoid complications. In other cases pneumothorax can develop without any known reason. Having such lung condition as pneumonia or cystic fibrosis can also lead to development of pneumothorax. Also, people who develop air blisters on their lungs are in the risk of developing pneumothorax, because if the blister ruptures it can lead to air leakage. According to Mayo Clinic, pneumothorax is most common among middle-aged people if it is caused by the air blisters that rupture. Also, it is more common among men.

Pneumothorax can become a life-threatening condition especially if the air leakage is big and a considerable part of the lung collapses. If pneumothorax is small, it may heal on its own. Nevertheless, the leaked air very often needs to be removed either by a special tube or a fine needle. 

Symptoms

• Acute chest pain
• Shortness of breath
• Difficulty breathing
• Coughing
• Dizziness
• Breathing difficulty

Diagnosis

• During a general examination the doctor will listen to the lungs to rule out other conditions. The doctor will ask if the person had any other pulmonary diseases such as pneumonia or air blisters.
• An X-ray or CT scan can show if there is an air leakage and its exact location. These tests can also rule out other conditions, which can be causing similar symptoms such as air blisters or pneumonia.
• A blood test can be ordered to determine if there is an infection in the lungs. They can also show signs of inflammation.
• Most commonly, doctors are able to draw a definitive conclusion using the findings of imaging tests, because pneumothorax shows itself clearly on X-ray and CT scan images.

Treatment

• Pleura plastic of the pleural defect is the surgery aimed to remove the leaked air from the lungs and also prevent new leakage.
• If pneumothorax was caused by air blisters, these blisters need to be treated as well.
• If there are signs of an infection, patient may need treatment with antibiotics to fight off harmful bacteria. It is especially indicated if pneumothorax was caused by pneumonia or other infections disease.
• After treatment, patient is recommended to lead healthy lifestyle, quit smoking if he/she does and also avoid excessive alcohol consumption.
• The patient may need to be checked up once half a year to prevent recurrence of pneumothorax.

Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed