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Pneumothorax

Overview

A collapsed lung, also called a pneumothorax, happens when air leaks into the space between your lung and the lining of your chest. This air buildup pushes on the lung, causing it to collapse, either completely or partially.

Imagine your lung as a balloon. If air gets into the space around the balloon, it squeezes the balloon, making it smaller. That's what happens in a pneumothorax.

This leakage can be caused by things like a blow to the chest, a stab wound, certain medical procedures, or problems with your lungs. Sometimes, there's no clear reason why it happens.

Common signs of a collapsed lung are sudden chest pain and trouble breathing. In some cases, this can be a serious medical emergency.

Treatment usually involves inserting a small tube (like a straw) between the ribs to remove the extra air. Sometimes, smaller cases of collapsed lungs can get better on their own.

Symptoms

A collapsed lung, called a pneumothorax, often causes sudden chest pain and trouble breathing. How much of your lung is collapsed affects how bad these symptoms are. This problem can result from different health issues, some of which are serious and potentially life-threatening. So, it's important to see a doctor. If your chest pain is intense or your breathing gets worse quickly, seek immediate emergency medical attention.

When to see a doctor

A collapsed lung (pneumothorax) can have various causes, and some are serious. If you have chest pain that's bad or if breathing gets harder and harder, you need immediate medical help. This is a serious condition that needs urgent attention.

Causes

A pneumothorax, where a lung collapses, can happen due to several reasons:

1. Chest Injuries: Any kind of chest injury, whether a direct hit (like from a punch or a car accident) or an accidental injury during a medical procedure (like a needle insertion), can damage the lung and cause it to collapse.

2. Lung Diseases: If your lungs are damaged, they're more likely to collapse. This damage can come from various illnesses, including: * Chronic Obstructive Pulmonary Disease (COPD): A long-term lung disease. * Cystic Fibrosis: A genetic disorder that affects the lungs and other organs. * Lung Cancer: A serious disease where abnormal cells grow in the lungs. * Pneumonia: An infection of the lungs. * Cystic Lung Diseases: Some rare lung conditions, like lymphangioleiomyomatosis and Birt-Hogg-Dube syndrome, create weak air sacs (blisters) in the lungs. These sacs can rupture and cause air to leak into the space around the lungs, leading to a pneumothorax.

3. Ruptured Air Blisters: Small air pockets (called blebs) can sometimes form on the top part of the lungs. If these pockets burst, air escapes into the space around the lung, causing it to collapse.

4. Mechanical Ventilation: People who need a breathing machine (ventilator) are at risk of a serious type of pneumothorax. The ventilator can sometimes create an uneven balance of air pressure in the chest, which can cause the lung to collapse completely.

Risk factors

Men are more often diagnosed with a pneumothorax than women. A type of pneumothorax, often caused by tiny air bubbles bursting in the lungs, is most common in people aged 20 to 40. Being very tall and underweight can increase the risk of this type.

Several things can raise the chances of getting a pneumothorax. Having lung problems or needing a breathing machine (mechanical ventilation) are important factors. Other risk factors include:

  • Smoking: The more cigarettes you smoke and the longer you've smoked, the greater your risk, even if you don't have emphysema. Smoking damages the lungs and makes them more vulnerable to air leaks.
  • Family history: Sometimes, a tendency toward pneumothorax seems to run in families. This suggests that genetics might play a role.
  • Past pneumothorax: If you've had a pneumothorax before, you're more likely to have one again. Your body might be more prone to lung air leaks after an initial episode.

Having a pneumothorax isn't just about chance; certain factors increase your vulnerability. Understanding these factors can help people take steps to protect their lung health.

Complications

Problems after a pneumothorax can differ. It depends on how big and serious the collapsed lung is, what caused it, and how it was treated. Sometimes, air might keep leaking if the hole in the lung doesn't heal properly. This can lead to the collapsed lung happening again.

Diagnosis

A collapsed lung (pneumothorax) is usually found by taking an X-ray of the chest. Sometimes, a more detailed picture called a CT scan is needed. A doctor might also use an ultrasound to look for a collapsed lung. At Mayo Clinic, our team of experts can help you with any lung-related health issues. We offer different ways to diagnose and treat this condition, including chest X-rays and CT scans.

Treatment

Treating a collapsed lung (pneumothorax) aims to reduce pressure on the lung so it can inflate again. Sometimes, doctors also try to prevent future collapses. The best treatment depends on how much of the lung is collapsed and your overall health.

Several options exist:

  • Observation: If only a small part of the lung is collapsed, your doctor might just watch it with X-rays. They'll wait for the extra air to go away and the lung to re-expand, which can take several weeks.

  • Needle aspiration or chest tube: If a larger area is collapsed, a needle or a small tube (chest tube) is used to remove the extra air.

    • Needle aspiration: A thin needle is inserted between the ribs into the space with extra air. The needle is removed, and a syringe attached to the needle removes the air. Sometimes, a small tube (catheter) is left in place for a while to make sure the lung stays inflated and the problem doesn't return.
    • Chest tube: A flexible tube is inserted into the space with extra air. This tube might connect to a special one-way valve that continuously removes air until the lung is fully healed.
  • Nonsurgical repair: If a chest tube doesn't work, there are ways to fix the leak without surgery. These include:

    • Irritating the tissues: A substance can be used to make the tissues around the lung stick together, sealing any leaks. This can sometimes be done through the chest tube or during surgery.
    • Using blood: Blood from your arm can be put into the chest tube. The blood forms a patch (called an autologous blood patch) that seals the leak.
    • Using a bronchoscope: A thin, flexible tube (bronchoscope) is inserted down your throat into your lungs to see the air passages and place a one-way valve. This valve lets the lung re-expand while the leak heals.
  • Surgery: In some cases, surgery is needed to close the leak. Most often, surgeons can use small incisions with a tiny camera and special tools to repair the area. Sometimes, a larger incision is needed for bigger leaks or multiple leaks.

Aftercare: After your lung heals, you might need to avoid certain activities that put extra pressure on your lungs, such as flying, scuba diving, or playing wind instruments. Talk to your doctor about any restrictions and schedule follow-up appointments to monitor your recovery.

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