What is pneumothorax?
Who gets pneumothorax?
What are the symptoms?
How is pneumothorax treated?
Are there any special precautions?
Will it happen again?
What about surgery?
Your lungs sit within a chest cavity. If you get a lung puncture, air escapes from the lung into the chest cavity (‘pneumothorax’ means ‘air in the chest’), and the lung partly collapses. Although this can be caused by an injury from broken ribs or even from some medical procedures, a ‘spontaneous’ pneumothorax happens without any warning.
Mostly healthy young men get pneumothorax. Their lungs are in good shape but they happen to have a weakness at the top of the lung which means it can pop. This defect is often invisible on chest X-rays and is only found during an operation. Even if the lung completely collapses, these people may not be really breathless. Older patients with chronic chest problems are also at risk of an unexpected pneumothorax, which even if small can cause major breathing problems. In both cases it is much more common if you smoke.
[TOP]
In younger people chest pain, worse on breathing, may be the major symptom (this happens because when the lung pops, there is a little bleeding), and some even wonder if they are having a heart attack. However, particularly in older people, the main effect is sudden unexpected breathlessness. The diagnosis is confirmed by a chest X-ray.
[TOP]
If you are only mildly breathless, you may be sent home just with painkillers. For a bigger collapse with more troublesome symptoms, it is often possible to suck the air out of the chest cavity using a small plastic tube inserted using local anaesthetic. Occasionally this doesn’t work and a large tube will have to be attached to a bottle of water to allow the air to bubble out, which means staying in hospital. If the lung still fails to heal, then you will have to have an operation. In any case you should be given a follow-up appointment to see the local chest specialist.
[TOP]
If you have just been sent home from hospital, you may notice bubbling noises in your chest as you breathe, particularly in bed, as the lung heals. You shouldn’t travel by air until told it is safe to do so. You don’t need to inform anybody, unless you are a scuba-diver. Since most episodes happen at rest, there is no reason why you can’t exercise normally. If you smoke, stop!
[TOP]
After one pneumothorax, the chance of it happening again is only 1 in 4, but rises to 1 in 3 (second episode) and 1 in 2 (third). Recurrence is uncommon after two years. You would easily recognise another episode and should then follow the specialist’s advice about whether to telephone the chest clinic or go to casualty.
[TOP]
If it keeps happening, or hospital treatment doesn’t work, your health professional will advise you to have an operation. This allows the weakness to be removed, and the lung becomes stuck to the chest so that it can’t collapse again. Often this can be achieved using keyhole surgery, so you may only be inactive for a few days.
[TOP]
Page last medically reviewed: Jan '05
