Pneumothorax
Summary/Definition
Pneumothorax is a condition in which air leaks out of the lung and fills the pleural cavity. In other words, it’s a condition in which air, for whatever reason, enters the hollow space and distorts the lungs, accompanied by chest pain and difficulty breathing. Pneumothorax can occur spontaneously: primary spontaneous pneumothorax in people without chronic lung disease, and secondary spontaneous pneumothorax in people with existing chronic lung disease. Other types of pneumothorax: are traumatic pneumothorax, and tension pneumothorax. In primary spontaneous pneumothorax, air bubbles in the lung inflate like balloons and spontaneously burst on its surface, forming a rupture through which the patient’s inhaled air leaks into the pleural cavity. Secondary spontaneous pneumothorax, unlike primary pneumothorax, occurs more often in elderly people or those with chronic lung diseases (asthma, pneumonia, pulmonary tuberculosis, chronic obstructive pulmonary disease, etc). A traumatic pneumothorax is a pneumothorax caused by an external trauma or wound. Tension pneumothorax can occur with both natural and traumatic pneumothorax and is a situation that results in severe oxygen deficiency and requires immediate emergency treatment.
Symptoms
The main symptoms of pneumothorax are chest pain and difficulty breathing. The chest pain usually starts suddenly and disappears after about 24 hours, and the degree of breathlessness depends on the patient’s condition. Usually, young patients without chronic lung disease do not have much difficulty breathing. Still, in patients with severe pneumothorax, breathing may be so difficult that the patient not only has difficulty breathing, but cyanosis may also occur.
Diagnostics
The easiest way to diagnose pneumothorax is to undergo a chest X-ray. Almost always, chest radiography can show the presence of the above symptoms in the subject. A physical examination of the pneumothorax may include percussion of the lesion area, detection of the hyperresonance, and auscultation for changes in breath sounds. More recently, diagnostic tests such as chest lung computed tomography (HRCT) have been performed to detect pneumothorax.
Treatment and course of the disease
The main objective of treatment is to remove the air leaked from the lungs into the chest cavity and restore the tightness and normal size of the lungs, taking measures to prevent recurrence. When a pneumothorax occurs, the patient must be kept in absolute rest, so they are usually hospitalized in a medical facility. A specific treatment for pneumothorax is selected after a comprehensive study of the patient’s condition, possible recurrence, and lung condition. If the symptoms are mild, oxygen can be administered and the condition can be observed to improve without any further treatment. If a mild to moderate pneumothorax is found and there are no characteristic symptoms, air can be removed from the chest cavity by applying thoracentesis. A pleural drainage tube is inserted into the chest cavity where the pneumothorax occurred; the other end is connected to a sealed drainage container; and air is removed through the inserted tube by expanding the lungs. Chemical pleurodesis and other types of surgical intervention are also used as treatments for pneumothorax.
