- What is pneumothorax?
Pneumothorax is a condition in which air leaks through a hole in the lung, causing air to fill the pleural space. As the amount of air leakage increases, the lungs cannot function normally. If the air in the chest cavity is not removed, the space between the lungs and heart can be pushed to the other side, leading to danger.
- Causes of pneumothorax
Pneumothorax is divided into spontaneous pneumothorax and traumatic pneumothorax, and appropriate tests are needed to determine the cause.
Spontaneous pneumothorax is divided into primary pneumothorax and secondary pneumothorax. Primary pneumothorax occurs in healthy people and is caused by small air sacs in the top membrane of the lungs. The cause of primary pneumothorax is unclear, but it is thought to be related to smoking, as most patients are tall, thin, and smoke. Secondary pneumothorax occurs in people who already have lung disease, including tuberculosis, malignant tumors, pulmonary fibrosis, chronic obstructive pulmonary disease, and emphysema.
Traumatic pneumothorax is caused by a car accident or by a wound caused by a sharp object, resulting in damage to the lung parenchyma due to chest trauma. Pneumothorax can also occur after a lung biopsy, and tension pneumothorax can also be caused by medical machines such as ventilators in the intensive care unit. Another reason is also related to menstrual regulation in women.
- Symptoms of pneumothorax
Common symptoms of pneumothorax include chest pain and difficulty breathing. Chest pain usually starts suddenly and goes away after about 24 hours, and most people complain of chest pain in different ways. They often report feeling “a lump in their back” or “every time they breathe, there’s a stabbing pain in their chest.”
Shortness of breath varies depending on the patient’s condition. Younger patients without pre-existing lung disease usually do not have severe shortness of breath. Patients with severe pneumothorax may have difficulty breathing to the point of being unable to breathe, which may be accompanied by cyanosis. A small number of patients report hearing a sudden ‘rattling’ sound in the chest when lying down or getting up from lying down, as well as the feeling of something moving.
- Diagnosis of pneumothorax
The easiest way to diagnose pneumothorax is with a chest X-ray. Chest X-ray with the above symptoms can be referred to for the diagnosis of pneumothorax in most cases. In addition, the diagnosis can also be based on the patient’s other test results. Pneumothorax can be suspected by percussion of the affected area, magnetic resonance spectroscopy, and decreased breath sounds on auscultation. A chest X-ray will be performed and read by a specialist to confirm pneumothorax.
In recent years, lung computed tomography (HRCT) has been performed and used to diagnose and establish treatment options. The purpose is to determine whether a patient with a pneumothorax requires surgical treatment. However, this test is not necessary for all patients, so you should consult a specialist to know what to look for.
- Treatment of pneumothorax
The principle of pneumothorax treatment is to remove the air leaking from the lungs in the chest cavity to cause lung recurrence, and effectively close the chest cavity to prevent recurrence. Treatment of pneumothorax is determined based on the patient’s condition and whether there has been a recurrence. The treatment time for pneumothorax is difficult to predict. Most patients need to be treated for about a week. Some patients can be treated for a long time, including spontaneous pneumothorax. In general, the treatment time for secondary pneumothorax is significantly longer than for spontaneous pneumothorax, and it is difficult to choose a treatment method, so you should follow the instructions of a specialist.
- Monitor & note pneumothorax
If the initial pneumothorax is treated with observation or chest tube placement alone, the probability of recurrence is approximately 50%. If you have relapsed twice, the risk of recurring more than 3 times is about 80 ~ 90%. Therefore, patients with recurrent pneumothorax need surgical treatment. The recurrence rate in patients who have undergone surgical treatment is approximately 5%.
At high altitudes, air sacs in the lungs can easily burst. People who have been diagnosed with pneumothorax or who are likely to have a recurrence should consult a specialist before traveling for an extended period of time.
Inhaling tobacco deeply and breathing heavily after strenuous exercise can increase chest pressure along with increased abdominal pressure. This pressure can easily burst the balloon-like bubbles in the thin pleura, so be careful.
