Overview

What is Pneumothorax?

“Pneumo” translates to air and “thorax” translates to the chest. As such, pneumothorax is the medical term for a collapsed lung that results in air finding its way into the pleural space (the space between the lungs and the chest cavity).

Traumatic Pneumothorax can occur as a result of a traumatic incident such as impact from motor accidents or sports collisions, broken ribs, bullet or knife wound to the chest, medical procedures such as CPR or biopsies that may damage the lungs and changes in surrounding air pressures common with scuba diving.

The most common form of pneumothorax that occurs without any cause is called a Spontaneous Pneumothorax.

This occurrence can be categorised into two specific events:

  • Primary Spontaneous Pneumothorax (PSP): Occurs in young, adolescent, thin and tall teens with no history of lung disease.
  • Secondary Spontaneous Pneumothorax (SSP): Occurs in older people with known lung problems from conditions such as lung cancer, cystic fibrosis, tuberculosis etc.

Symptoms of Pneumothorax

Symptoms can range from mild to life-threatening. Mild cases of pneumothorax may go unnoticed. Common symptoms include:

  • Chest Pain
  • Shortness of breath
  • Coughing
  • Fatigue
  • Fast Breathing
  • Rapid Heartbeat

Investigation

X-Ray

This is the most common method used to achieve a diagnosis. It will also tell the doctor the extent and severity of the condition.

CT Scan

To assess for any underlying lung conditions the patient may be experiencing. It also helps to assess the condition of the opposite lung of patients who do.

Ultrasound

Used to assess the severity of the condition and to aid in insertion of chest tube during treatment.

Treatments

Conservative Approach

For those with minor cases of PSPs, the surgeon may suggest monitoring the condition closely. It would usually resolve within the first 24-48 hours. In some cases, patients may experience a drop in oxygen levels in the lungs known as hypoxia. This will be treated with nasal oxygen supplementation.

Thoracostomy (Chest Tube Insertion)

A hollowed needle is carefully inserted into the pleural cavity following by the insertion of a chest tube to allow the air to drain and the lung to re-inflate to heal.

Surgery

If a patient has experienced more than one incident of spontaneous pneumothorax or if there is a large amount of air trapped within the pleural cavity, not allowing the lungs to re-expand, surgery would be recommended. Rarely, some occupations and lifestyles become an indication for surgery.

The surgery is performed through Video-Assisted Surgery involving 2-3 keyhole incisions which also involves doing a bullectomy and Pleurodesis [fusion of pleura] so that the pneumothorax doesn’t recur. Patients are usually discharged 2-3 days after surgery.

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