Pneumothorax (collapsed lung)

Chest | Pulmonology | Pneumothorax (collapsed lung) (Disease)


The lungs are lined with a double layer of membrane (pleura) , the inner one covering the lung surface and the outer one covering the inside of the chest wall, separating them from the chest wall. If air gets between these two layers, into what is known as the pleural space, its called a pneumothorax. Once air is drawn into this space, it cannot easily escape and the air compresses the lung and interferes with the mechanics of breathing. This makes the lung collapse, causing chest pain and making breathing difficult. Also, this buildup of air puts pressure on the lung, so it cannot expand as much as it normally does when you take a breath.

Symptoms include: chest pain and tightness, shortness of breath and dry cough. The severity of symptoms depends on how much air gets into the space. In a particular type, called a tension pneumothorax, which is a medical emergency, the air gets into the space but cannot escape at all, and with each breath more air is drawn in. Under these circumstances, chest pain and shortness of breath are severe and may rapidly worsen as the lung and chest contents are compressed. Blood is prevented from returning from the lungs to the heart because of the high pressure caused by the trapped air. This results in low blood pressure and collapsed lungs.

Causes and Risk factors

Pneumothorax can be caused by a chest injury, underlying lung disease or ruptured air blisters (blebs). Pneumothorax also can occur for no obvious reason. Any blunt or penetrating injury to the chest can cause lung collapse. Some injuries may happen during physical assaults or car crashes, while others may inadvertently occur during certain medical procedures.

Diagnosis and Treatment

A pneumothorax is generally diagnosed using a chest X-ray. In some cases, computerized tomography (CT) may be needed to provide more detailed images. CT scanners combine X-ray images taken from many different directions to produce cross-sectional views of internal structures.

A minor pneumothorax may require observation by the doctor. Sometimes, oxygen may be given. More serious cases are treated by inserting a needle or a chest tube into the chest cavity. Both of these procedures relieve the pressure on the lung and allow it to re-expand. Surgery may be needed if the original treatment does not work or if the pneumothorax returns. ...