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In medicine (pulmonology), a pneumothorax, or collapsed lung, is a potential medical emergency caused by accumulation of air or gas in the pleural cavity. A pneumothorax can occur spontaneously, or as the result of disease or injury.
It most commonly arises:
It may also be due to:
Pneumothoraces are divided into tension and non-tension pneumathoraces. A tension pneumothorax is a medical emergency as air accumulates in the pleural space with each breath. The increase in intrathoracic pressure results in massive shifts of the mediastinum away from the affected lung compressing intrathoracic vessels. A non-tension pneumothorax by contrast is a less severe pathology because there is no ongoing accumulation of air and hence no increasing pressure on the organs within the chest.
The accumulation of blood in the thoracic cavity (hemothorax) exacerbates the problem, creating a hemopneumothorax.
Sudden shortness of breath, dry coughs, cyanosis (turning blue) and pain felt in the chest, back and/or arms are the main symptoms. In penetrating chest wounds, the sound of air flowing through the puncture hole may indicate pneumothorax, hence the term “sucking” chest wound. The flopping sound of the punctured lung is also occasionally heard. Subcutaneous emphysema is another symptom.
If untreated, hypoxia may lead to loss of consciousness and coma. In addition, shifting of the mediastinum away from the site of the injury can obstruct the superior and inferior vena cava resulting in reduced cardiac preload and decreased cardiac output. Untreated, a severe pneumothorax can lead to death within several minutes.
Spontaneous pneumothoraces are reported in young people with a tall, skinny stature. There is a preponderance among males, possibly because men are in general taller than women. The reason for this association, while unknown, is hypothesized to be the presence of subtle abnormalities in connective tissue. Some spontaneous pneumothoraces however, are results of “blebs”, blister like structures on the surface of the lung, that rupture allowing the escape of air into the pleural cavity.
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