Pneumothorax

Alternative names

Air around the lung; Air outside the lung

Definition

A pneumothorax is collection of air or gas in the space surrounding the lungs.

Causes, incidence, and risk factors

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

See also spontaneous pneumothorax, traumatic pneumothorax, and tension 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.

Additional symptoms that may be associated with this disease:

• Nasal flaring
• Anxiety, stress, and tension
• Hypotension (low blood pressure )

Signs and tests

Stethoscope examination of the chest reveals decreased or absent breath sounds on the affected
side.

Tests include:

• Chest x-ray to determine presence of air outside the lung

• Arterial blood gases
Treatment

Small pneumothoraces may go away on their own.

Larger pneumothoraces require the removal of air from around the lung. A chest tube (chest tube
insertion ) placed between the ribs into space surrounding the lungs helps clear the air and allows
the lung to re-expand. This may take several days (the chest tube is left in place). The patient
must stay in the hospital while the chest tube is in place.

Supplemental oxygen may be needed to help air around the lung be reabsorbed more quickly.

Surgery may be needed to prevent recurrent episodes.

Expectations (prognosis)

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

Complications

• Recurrent pneumothorax
• Tension pneumothorax with shock

Calling your health care provider

Call your health care provider if symptoms of pneumothorax develop, especially if you have
previously experienced this condition.

Prevention

There is no known prevention, other than to decrease risk by stopping smoking.

References

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.

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