Pneumothorax

What is a pneumothorax?

  • A pneumothorax is an air leak (usually from the lung) that accumulates in between the linings of the lung (pleural space) causing lung to collapse.


  • The lining of the lung is called “pleura” which covers the lungs and the inner surface of your chest wall.


  • Depending on size of air leak, this may lead to a collapse of lung which sometimes may be life threatening if not treated immediately.

Symptoms?

  • Most common symptom of pneumothorax includes a sharp, sudden chest pain that gets worse on deep breathing or coughing, and/or a sudden episode of breathlessness.


  • The symptoms of pneumothorax depend on the size of air leak causing lung collapse, and also on the underlying condition of your lungs.

Causes?

  • There may be no obvious cause found in most healthy individuals.


  • This is called “Primary Spontaneous Pneumothorax” (PSP), and is more common in tall and thin individuals.


  • It is also more common in smokers.


  • The other form of Pneumothorax is called “Secondary Spontaneous Pneumothorax” (SSP), which happens in individuals with underlying chronic lung conditions such as COPD, asthma or cystic fibrosis.


  • There are other less common reasons such as injury to chest wall or rarely due to complications from medical and surgical procedures such as biopsy of lung tissue or lung linings.

Treatment?

  • Treatment depends on the cause and the size of lung collapse.


  • It may heal on its own without needing an intervention as the air gets naturally reabsorbed.


  • If the air leak is bigger and you are having symptoms, you may need drainage of air leak by syringe

and needle, or by putting a small plastic tube (chest drain) under local anaesthetic.


  • The team looking after you will explain you further what the best treatment is recommended for you.


  • If there is recurrence, or if the air leak is not healing then sometimes an operation may be needed.

What should I do when I go home?

  • Return to the Emergency department if you have worsening chest pain or breathlessness.


  • Avoid smoking as this significantly increases the chances of recurrence of pneumothorax. If you wish you can be referred to smoking cessation team to help you with stopping smoking.


  • Avoid heavy weight lifting or straining yourself in the initial few days after discharge. You can resume your daily activities and go back to work after you are discharged from hospital.


  • Avoid air travel until you are advised by your doctor that this is safe, this is usually a week after complete resolution of your pneumothorax as confirmed by a repeat chest x ray.


  • You will be advised if you need to come back for a follow up appointment in the chest clinic for a repeat chest x-ray after you are discharged from the hospital.


  • If you take part in a recreational activity or jobs that involves a sudden change in atmospheric pressure like diving or flying, please contact your medical team for further advice.