Pneumothorax

Pneumothorax
collapsed lung
A large right-sided spontaneous pneumothorax (left in the image). An arrow indicates the edge of the collapsed lung
Specialty	pulmonology, thoracic surgery
Symptoms	chest pain, shortness of breath, tiredness
Usual onset	sudden
Causes	unknown, trauma
Risk factors	COPD, tuberculosis, smoking
Diagnostic method	chest X-ray, ultrasound, CT scan
Differential diagnosis	lung bullae,hemothorax
Prevention	stopping smoking
Treatment	conservative, needle aspiration, chest tube, pleurodesis
Frequency	20 per 100,000 per year
[]

A pneumothorax is an abnormal collection of air in the pleural space that causes an uncoupling of the lung from the chest wall. Symptoms typically include sudden onset of sharp, one sided, chest pain and shortness of breath. In a minority of cases the amount of air in the chest increases when a one-way valve is formed by an area of damaged tissue, leading to a tension pneumothorax. This condition can cause a steadily worsening oxygen shortage and low blood pressure. Unless reversed by effective treatment, it can result in death. Very rarely both lungs may be affected by a pneumothorax. It is often called a collapsed lung, although that term may also refer to atelectasis.

A primary pneumothorax is one that occurs without an apparent cause and in the absence of significant lung disease, while a secondary pneumothorax occurs in the presence of existing lung disease. Smoking increases the risk as do lung diseases including COPD, asthma, and tuberculosis. A pneumothorax can also be caused by physical trauma to the chest (including a blast injury), or as a complication of a healthcare intervention; in which case it is called a traumatic pneumothorax.

Diagnosis of a pneumothorax by physical examination alone can be difficult (particularly in smaller pneumothoraces). A chest X-ray, computed tomography (CT) scan, or ultrasound is usually used to confirm its presence. Other conditions that can result in similar symptoms include a hemothorax (buildup of blood in the pleural space), pulmonary embolism, and heart attack. A large bullae may look similar on a chest X-ray.