What is pneumothorax?

A pneumothorax is the medical term for what is commonly known as a collapsed lung. It is reasonably common and has many different causes.

A pneumothorax occurs when air leaks into the space between the lung and chest wall (called the pleural space). This air pushes on the lung, which makes it collapse. In most cases, only some of the lung collapses.

How severe the collapse depends on the amount of air trapped in the pleural space

What are the symptoms of pneumothorax?

The most common symptom of pneumothorax is a sudden, sharp stabbing pain on one side of the chest, made worse by breathing in.

If you have a pneumothorax, you might also have breathing problems. Other symptoms may include:

• fast heart rate
• blueish lips and skin
• breathlessness
• cold sweats
• constant ache and tightness in the chest
• sharp pain when breathing in
• fast and shallow breathing

If you have a pneumothorax and you feel it is getting harder to breathe, call triple zero (000) for an ambulance.

What are the types of pneumothorax?

There are different types of pneumothorax:

• Primary spontaneous pneumothorax (PSP): this type of pneumothorax is the most common, has no known cause and develops in otherwise healthy people. It is thought to be caused by a tiny tear of an outer part of the lung. PSP is more common in tall people and mainly affects healthy young adults without lung disease.
• Secondary spontaneous pneumothorax (SSP): SSP develops as a complication of existing lung disease, such as chronic obstructive pulmonary disease (COPD), pneumonia, tuberculosis, sarcoidosis or cystic fibrosis. The lung disease weakens the edge of the lung in some way, making the lung more likely to tear and cause air to escape.
• Traumatic pneumothorax: this type of pneumothorax is caused by an incident such as a car accident, broken ribs or a stab wound.
• Latrogenic pneumothorax: this is a pneumothorax that occurs as a result of mechanical ventilation, which causes an imbalance in the air pressure around the lungs.
• Tension pneumothorax: this is a pneumothorax (of any type) that leads to the heart and lungs not working properly due to high pressure in the air around the lung. It is a medical emergency.

How is pneumothorax diagnosed?

A chest x-ray is used to diagnose a pneumothorax, though an ultrasound or CT scan are sometimes used.

How is pneumothorax treated?

Treatment will be guided by the type of pneumothorax and the symptoms, not by the size of the pneumothorax alone.

If you do not have any symptoms, and the pneumothorax is small, it might clear up on its own. You will probably have a repeat x-ray to check that it has cleared up. You might need medicine if you are in pain.

If you are significantly breathless, you will need treatment to have the trapped air removed. This is called aspiration and involves inserting a thin tube into the chest wall (using a local anaesthetic to numb the skin).

A large syringe is then attached to the thin tube, which sucks out the air from inside the chest wall. This is repeated until the pneumothorax has gone.

Sometimes people will need a procedure called a pleurodesis, which sticks the lung to the chest cavity. This may be used to prevent further collection of air, or if the pneumothorax isn’t getting better after a few days

There are several types of surgical options to treat pneumothorax.

If you have a pneumothorax, you are at risk of having another one. See your doctor straight away if you develop symptoms. It might be too dangerous to fly in an aeroplane. Before you travel, you will need clearance from your doctor. You should never go diving if you’ve had a pneumothorax.

Can pneumothorax be prevented?

If you have had a spontaneous pneumothorax (PSP or SSP) previously, you might need treatment to prevent it happening again. It is a good idea to talk to a lung specialist to discuss your treatment and prevention options.

Quitting smoking can reduce your risk of pneumothorax.