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pneumothorax

A pneumothorax is an abnormal collection of air in the pleural space between the lung and the chest wall. Symptoms usually include a sudden onset of sharp, one-sided chest pain and shortness of breath. In a few cases, the one-way valve forms from an area of damaged tissue, and the amount of air increases in the space between the chest wall and the lungs; This is called a compressive pneumothorax. This can cause steadily worsening hypoxia and low blood pressure. This leads to a type of shock, which can be fatal unless reversed. In very rare cases, both lungs may be affected by a pneumothorax

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There are different types of pneumothorax. Primary spontaneous pneumothorax is one that occurs without apparent cause and in the absence of significant lung disease. It usually occurs in young males.  while secondary spontaneous pneumothorax occurs in the presence of existing lung disease. Smoking increases the risk of primary spontaneous pneumothorax, while the main underlying causes of secondary pneumothorax are chronic obstructive pulmonary disease, asthma and tuberculosis.

 

It can be difficult to diagnose a pneumothorax by physical examination alone (especially in a simple pneumothorax). Usually a chest X-ray or CT scan is used.

 

Less than 10% of simple spontaneous pneumothoraxes usually resolve without treatment and require only inpatient monitoring. This approach may be more appropriate for people who do not have an underlying lung disease. In the case of a larger pneumothorax, or if there is shortness of breath, air can be removed with a syringe or chest tube connected to a one-way valve system or to a vial containing water.  Sometimes, surgery may be required if tube drainage is unsuccessful, or as a preventative measure, if there are recurrent episodes, or if the pneumothorax is left and right and in some jobs such as pilots. Surgical treatments usually involve pleurodesis (in which the layers of the pleura are induced to adhere together) or pleurectomy (surgical removal of the pleural membranes).

Previously, the surgery was performed in the traditional open surgical method, while it is currently performed by thoracoscopic surgery through small holes from the side of the chest.

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