Pneumothorax - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

A pneumothorax is an accumulation of air in the pleural space.
Primary spontaneous pneumothoraces occur mostly in young people without known respiratory illnesses; smoking, male sex, and increased height are known associations. Patients with pre-existing pulmonary diseases may develop secondary spontaneous pneumothoraces.
A secondary spontaneous pneumothorax occurs in relation to a known lung disease.
A tension pneumothorax, when intrapleural pressure exceeds atmospheric pressure throughout expiration, is a medical emergency that requires immediate intervention to decompress (needle or open) the involved hemithorax.
Patients with pneumothoraces typically complain of dyspnea and chest pain. In tension pneumothorax, patients are distressed with rapid labored respirations, cyanosis, profuse diaphoresis, tachycardia, and eventually shock.

Anterior-posterior chest x-ray demonstrating a right pneumothorax

From the collection of Dr Ryland P. Byrd

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Definition

Epidemiology

Etiology

Pathophysiology

Images

Anterior-posterior chest x-ray demonstrating a right pneumothorax
Entrapped lung with pneumothorax ex-vacuo. This patient had a malignant pleural effusion that had developed a thick visceral pleural cortical rind preventing re-expansion. Chest tube was for pleural effusion removal, not evacuation of air.
POCUS of the lung in a large pneumothorax. Shown is the ultrasound view showing A-lines that are reverberations of the pleural line. There is a lack of B-lines, which is also consistent with a pneumothorax. M-mode is placed on the patient and shows a 'barcode sign' confirming presence of air in the pleural space

Citations

Key Articles

British Thoracic Society. Guidelines: pleural disease. Jul 2023 [internet publication].[Full Text]
American College of Radiology. ACR appropriateness criteria: intensive care unit patients. 2020 [internet publication].[Full Text]
American College of Radiology. ACR appropriateness criteria: rib fractures. 2018 [internet publication].[Full Text]
British Thoracic Society. Clinical statements: pleural procedures. Jul 2023 [internet publication].[Full Text]

Referenced Articles

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