Simple pneumothorax occurs when air accumulates between the chest wall and the lung because of an injury. It causes the lung to collapse partially or completely.
People have chest pain and sometimes feel short of breath.
Usually, a chest x-ray is taken.
Usually, a tube (thoracostomy tube) is inserted into the chest to remove the air and allow the lung to reinflate.
(See also Introduction to Chest Injuries.)
Pneumothorax may result when blunt force (such as a motor vehicle crash or fall) or a penetrating injury (such as a stab or gunshot wound) damages the lungs and/or airways. The damage allows air to leave the lung and collect between the lung and the wall of the chest. Air from the pneumothorax may also leak into the skin of the chest or neck. Many people also have blood in the pleural space (hemopneumothorax).
This video shows the development of a pneumothorax caused by an injury to the lung. Air leaks from the injury into the
MohammedElAmine/stock.adobe.com
This video shows the development of a pneumothorax caused by an injury to the lung. Air leaks from the injury into the space between the lung and chest wall (pleural space), eliminating the negative pressure that normally keeps the lung expanded. As air accumulates, the affected lung partially or completely collapses, reducing the ability to bring oxygen into the body.
(Video has no audio.)
MohammedElAmine/stock.adobe.com
Pneumothorax of both lungs is very dangerous. However, most often only one lung is affected. A pneumothorax that affects only one lung is rarely dangerous unless people have a chronic lung disorder (such as asthma or COPD [chronic obstructive pulmonary disease]) or unless the pneumothorax is a tension pneumothorax or an open pneumothorax (a pneumothorax that connects to an open wound in the chest wall).
Symptoms of Simple Pneumothorax
People have chest pain. Most of the pain is due to the injury that caused the pneumothorax. They may feel short of breath or breathe rapidly and feel that their heart is racing, particularly if the amount of air is large.
If air accumulates under the skin, the skin feels crackly and makes a crackling sound when touched.
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Diagnosis of Simple Pneumothorax
Chest x-ray
Doctors usually diagnose a pneumothorax based on a chest x-ray. Sometimes pneumothorax is diagnosed when computed tomography (CT) or ultrasound is done to diagnose other chest or abdominal injuries.
Treatment of Simple Pneumothorax
Usually removal of air from the pleural space
The goal of treatment is to remove the air from the pleural space and allow the lung to reinflate. Usually, a tube (thoracostomy or chest tube) is inserted into the chest between 2 ribs. The tube is attached to a suction device to remove the air and to allow the lung to reinflate. This procedure can be done using only a local anesthetic.
However, if the amount of air is small and causes no symptoms, doctors may not remove the air at all, because a small pneumothorax often goes away on its own. Or doctors may insert a small catheter (drain) to remove the air. Whatever the treatment, doctors typically keep the person in the hospital for observation to make sure the pneumothorax does not worsen.
