Pneumothorax: Causes, Symptoms, Risk Factors, Types, Diagnosis and Treatment

Collapsed lungs are known as pneumothoraxes. When air leaks into the area where your lung and chest wall meet, it causes a pneumothorax. Both the conditions that is a full lung collapse and a partial lung collapse are considered pneumothoraxes.

A pneumothorax can be brought on by a piercing or blunt chest wound, by some medical procedures, or by lung disease that has already impacted the patient's lungs or it could happen for no apparent cause at all.

 Sudden chest discomfort and breathing difficulties are frequently present symptoms. A collapsed lung may pose a hazard to life in certain circumstances. To remove the extra air, a chest tube or needle is typically inserted between the ribs as part of the treatment for pneumothorax. But a mild pneumothorax may heal on its own.

Causes Of Pneumothorax

An injury to the lung may result in a collapsed lung. A stab or gunshot wound to the chest, a broken rib, or specific medical treatments are examples of injuries.

Air blisters on the lung (referred to as blebs) that rupture and let air into the area around the lung can occasionally lead to a collapsed lung. When traveling to a high altitude or scuba diving, for example, air pressure variations may cause this.

A collapsed lung is more likely to occur in tall, skinny people who smoke.

The likelihood of developing a collapsed lung is also increased by pulmonary conditions. These comprise:

• Asthma
• A chronic lung condition is known as COPD
• Chronic fibrosis
• Tuberculosis
• Whooping cough
• A collapsed lung can occasionally happen on its own. Known as a spontaneous pneumothorax

Symptoms Of Pneumothorax

If a pneumothorax develops as a result of trauma, the symptoms frequently show up right away or soon after. At rest, a person may experience the signs of a spontaneous pneumothorax. Often, the initial symptom is an abrupt episode of chest pain.

Possible signs include:

• Fast breathing or shortness of breath (dyspnea) that causes the skin to become blue (cyanosis) and an instantaneous, intense, stabbing pain in the chest
• Minimal blood pressure
• An enlarged jugular vein
• One side of the lungs expanding more than the other
• A hollow sound when you touch your chest
• Lethargy 
• Anxiety

Risk Factors Of Pneumothorax

The prevalence of pneumothorax is significantly higher in men than in women. The age group between 20 and 40 years old has the highest risk of experiencing the type of pneumothorax brought on by ruptured air blisters, particularly if the individual is extremely tall and underweight.

A pneumothorax may be caused by underlying lung illness or a risk factor such as mechanical ventilation. Additional danger signs consist of:

• Smoking- The risk rises with the duration and quantity of smoking.
• Genetics- There seems to be a familial relationship with some types of pneumothorax.
• Previous Pneumothorax. One pneumothorax increases the chance of subsequent ones for anyone who has experienced one.

Types Of Pneumothorax

A break in the lung surface that allows air to enter the pleural cavity during inspiration but prevents air from escaping during expiration is what leads to a tension pneumothorax. There is a one-way valve created by the breach. Lung collapse results as a result.

Pneumothoraces can have a variety of causes, and each one is categorised based on those causes.

• Primary Pneumothorax
  • Additionally known as a primary spontaneous pneumothorax or a spontaneous pneumothorax. It is distinguished by having no recognised underlying pulmonary pathology and no obvious cause. Smoking, family history, or the rupture of the bulla, which are tiny air-filled sacs in the lung tissue, may all be contributing factors, but they won't really cause a pneumothorax.
• Secondary Pneumothorax 
  • It is also known as a complex pneumothorax or a non-spontaneous pneumothorax. It develops because of an underlying lung disease such COPD, asthma, tuberculosis, cystic fibrosis, or whooping cough.
• Tension or non tension Pneumothorax
  • There are two other categories of pneumothorax tension and non-tension. By placing an underwater drain in the pleural cavity through the surgical incision, air is removed from the pleural space.
  • A shock could result from the heart's inability to pump properly due to the increased pressure. Since there is no continued buildup of air and hence no increased pressure on the organs and chest, a non-tension pneumothorax is not regarded as being as serious.
• Traumatic Pneumothorax
  • A pneumothorax can also be caused by trauma or by receiving subpar medical attention.
  • Trauma to the lungs results in a traumatic pneumothorax. These are a few of the contributing factors: Stab wounds, gunshot wounds, car accident injuries, or any other type of lung trauma.
• An iatrogenic pneumothorax is one that occurs as a result of a medical operation or poor medical care, such as an accidently punctured lung during surgery.

Diagnosis Of Pneumothorax

A pneumothorax patient frequently requires immediate medical attention, and emergency physicians will perform the assessment and diagnosis.

The area around the lungs will be examined by a specialist for indications of air.

They'll inquire about:

• Symptoms
• Recent activities 
• personal and family medical history
• Any past pneumothorax cases

They might additionally perform imaging tests like:

• A thoracic ultrasound
• A CT scan
• X-ray

Treatment Of Pneumothorax

The objective of treating a pneumothorax is to release the pressure on your lung so that it may expand once more. Preventing recurrences may be a secondary objective, depending on the origin of the pneumothorax. Depending on the extent of the lung collapse and occasionally on your general health, several approaches are used to accomplish these goals.

Observation, chest tube insertion, needle aspiration, nonsurgical repair, and surgery are all possible forms of treatment. To hasten lung expansion and air absorption, you can receive more oxygen therapy.

• Observation
  • Your doctor may only use a series of chest X-rays to monitor your condition if only a small piece of your lung is collapsed, waiting until the extra air has been totally absorbed and your lung has re-expanded. This could take a few weeks.
• Chest tube insertion or Needle Aspiration
  • A chest tube or needle will probably be used to drain the extra air if a significant portion of your lung has collapsed.
• Aspiration with a needle- Between the ribs, a hollow needle with a thin, flexible tube (catheter) is introduced into the air-filled cavity that is pressing on the collapsed lung. The doctor then takes out the needle, connects a syringe to the catheter, and draws out extra air. To guarantee that the lung has inflated once again and the pneumothorax has not returned, the catheter may be left in for a few hours.
• Inserting a chest tube- The air is continuously removed from the chest cavity using a flexible chest tube that may be linked to a one-way valve device until your lung has fully recovered and expanded.
• A Non-Surgical Fixation- Nonsurgical methods to stop the air leak could be used if a chest tube doesn't expand your lung:
• Using an irritant to cause the tissues around the lung to adhere to one another and plug any leaks. This may be carried out during surgery or through the chest tube.
• Filling the chest tube with blood after drawing it from your arm. The blood seals the air leak on the lung by forming a fibrinous patch (autologous blood patch).
• Putting a one-way valve after passing a tiny tube (bronchoscope) down your neck and into your lungs to examine your lungs and airways. The valve permits the air leak to close and the lung to re-expand.
• Surgery Sometimes surgery may be required to stop the air leak. The majority of the time, the procedure can be carried out through small incisions, with the help of a tiny fiber-optic camera and slender, long-handled surgical instruments. 

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