Pneumothorax (Collapsed Lung) | Display Patient Information Leaflets

Date issued: December 2022 

Review date: December 2024

Ref: A-564/NB/ED/Pneumothorax (Collapsed Lung)

PDF:  Pneumothorax Collapsed Lung final December 2022.pdf [pdf] 139KB

What is a pneumothorax (new-mo-thor-ax)?

This means the lung has collapsed and there is air between the lung and the chest wall.  Normally this space is very small and only contains some lubricating fluid, but lung damage means air leaks into the space as well.

They can occur following injury or spontaneously.  Spontaneous pneumothoraces are more common in men, smokers and those with underlying lung disease.

Symptoms include chest pain, shortness of breath and a dry cough.

What is the treatment?

This depends on several factors:

• The cause of the pneumothorax (spontaneous or traumatic)

• Whether or not you have underlying lung disease

• What symptoms you have

• How big the pneumothorax is.

Generally speaking, if your pneumothorax was caused by trauma or is very large or making you short of breath then we will need to remove it either by sucking the air out through a needle or by placing a tube called a chest drain.  In the latter case you will need to stay in hospital but you may be able to go home if only a needle is required (aspiration of the pneumothorax).

If it is very small and isn’t causing breathing difficulties, then it is very likely to resolve without treatment.

Whether or not it is drained, it is important that you return to clinic in 7-10 days (you will be given an appointment before leaving the Emergency Department).

Can I take painkillers?

• Paracetamol is useful to ease pain. It is best to take it regularly for a few days or so, rather than every now and then. An adult dose is two 500 mg tablets, four times a day. A doctor may pre-scribe additional painkillers such as codeine if the pain is more severe.   If you are prescribed a combination of paracetamol and codeine (e.g., cocodamol or codydramol) then it is important not to take additional paracetamol as you will accidentally overdose

• Anti-inflammatory medication can be used with paracetamol or as an alternative. There are many types and brands. They relieve pain and reduce inflammation and swelling (often the cause of the pain). You can buy ibuprofen at pharmacies or supermarkets without a prescription. The dose varies depending on your age and other medical problems. Side-effects sometimes occur with anti-inflammatory painkillers. Ask your doctor or pharmacist for advice regarding them

If pain is not controlled by these simple painkillers, do not exceed the recommended dose but see your general practitioner to discuss the possibility of stronger painkillers.

South Tees Hospitals NHS Foundation Trust

Emergency Department and Minor Injury Unit

You have been given this information because you have been diagnosed with a pneumothorax.

A pneumothorax (collapsed lung) occurs when air is trapped between a lung and the chest wall. This can occur from an injury, such as broken ribs or a wound to the chest, but commonly occurs spontaneously. Spontaneous pneumothorax is thought to be due to a tiny tear of an outer part of the lung.

Treatment of a pneumothorax

A small pneumothorax may require no treatment.

A larger pneumothorax, that is causing shortness of breath, may be treated with a tube inserted into the chest known as a chest drain.

Recovering from a pneumothorax

Flying

If you currently have a pneumothorax you should not fly at all. This is because of the risk of the trapped air expanding and causing a tension pneumothorax (a life-threatening emergency), which can happen when the air pressure around you changes.

If you have had a recent pneumothorax you should have a chest x-ray performed prior to flying to ensure that it has resolved.

It is recommended that you wait at least 1 week after this chest x-ray before flying, or 2 weeks if your pneumothorax was caused by an injury.

The risk of recurrence does not fall significantly for at least 1 year, and is higher in those with coexisting lung disease. You may wish to consider alternative forms of transport during this time.

Scuba diving

This also increases the risk of developing a tension pneumothorax.

You should not scuba dive if you have ever had a spontaneous pneumothorax. If your occupation relies on diving, you may be suitable for an operation to prevent recurrence and allow you to dive again.

You may be able to dive if you have had a traumatic pneumothorax, but this depends on further investigation. Please discuss this with your GP.

Follow-up after a pneumothorax

You will be given a clinic appointment to ensure your pneumothorax has resolved. This will involve a chest x-ray.

You should seek urgent medical attention if any of the following occur:

• Increased shortness of breath
• Severe sharp, stabbing chest pain (pleuritic pain)

Treating pain

If needed, painkiller options include the following:

• Paracetamol is usually recommended for painful sprains or strains.

• Non-steroidal anti-inflammatory drugs (NSAIDs) relieve pain and may also limit inflammation and swelling. You can buy some types (for example, ibuprofen) at pharmacies, without a prescription either topically as a cream, or as tablets. You should check the medication advice leaflet to ensure you are safe to take these as some patients with asthma or stomach ulcers may not be able to.

If this does not help, you may need an additional stronger painkiller – such as codeine – you should discuss this with your pharmacist or GP.

For further advice and information about your condition, please choose from the following:

• ‘NHS Patient Choices’ website: www.nhs.uk
• ‘Making Lives Better’ patient website: www.patient.info
• Telephone NHS 111
• Contact your General Practitioner

Contact details

• The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW
  Telephone: 01642 850850
• The Friarage, Northallerton, North Yorkshire, DL6 1JG
  Telephone: 01609 779911
• Redcar Primary Care Hospital, West Dyke Road, Redcar, TS10 4NW
  Telephone: 01642 511000

Patient experience

South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.

This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.

To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.

T: 01642 835964
E: [email protected]

The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW.

Telephone: 01642 850850

ST1614

Page published:
10/12/2021

Page last updated:
03/03/2023

Spontaneous pneumothorax in Kyiv – private clinic Oberig.

Pneumothorax, spontaneous

Pneumothorax is an accumulation of air in the pleural cavity. With pneumothorax, the lung collapses. Lung collapse can be partial (limited) or complete.

Spontaneous pneumothorax is not associated with lung injury, infectious destruction of lung tissue, or medical procedures. There are primary spontaneous pneumothorax, which develops in patients without clinically significant signs of lung pathology, and secondary – arising against the background of existing lung diseases.

Rarely, pneumothorax occurs due to a non-pulmonary pathology, such as catamenial pneumothorax. It occurs 24 hours before or within 72 hours after the onset of menstruation, and is caused by foci of endometriosis in the chest cavity.

Bullous emphysema is the cause of primary spontaneous pneumothorax in 90% of cases. With this disease, so-called bullae are formed in the lungs – small thin-walled cavities filled with air. The bullae may rupture, and then air enters the pleural cavity. In the prevention of pneumothorax, smoking cessation is of great importance, which contributes to the development of chronic lung diseases, including bullous emphysema.

DIAGNOSTICS OF SPONTANEOUS PNEUMOTHORAX

The main diagnostic method for spontaneous pneumothorax is radiography. In most cases, radiography is sufficient to confirm or exclude the diagnosis of pneumothorax. The doctor sees on x-ray a thin line of visceral pleura that is separated from the chest, or other signs of pneumothorax.

If in doubt, computed tomography (CT) is done. This method is useful for the diagnosis of small pneumothoraxes, as well as the differential diagnosis of large bullae and pneumothorax. CT is also used to determine the cause of secondary spontaneous pneumothorax.

SYMPTOMS AND SIGNS OF SPONTANEOUS PNEUMOTHORAX

Spontaneous pneumothorax usually occurs suddenly, against the background of normal health. Although in some cases it can be provoked by physical activity, coughing, sudden movement.

The main symptoms of spontaneous pneumothorax are shortness of breath, chest pain, dry cough. The pain can be both sharp and aching, weak. It is most pronounced in the first hours after the collapse of the lung. The pain is caused by the irritating effect of air on the pleural sheets. Gives to the neck, less often to the stomach or arm. The disease is easily confused with intercostal neuralgia.

The consequences of pneumothorax can be dangerous. If a large amount of air accumulates in the pleural cavity, the mediastinal organs, including the heart, are displaced. Other complications include hemothorax, an accumulation of blood in the chest cavity.

TREATMENT OF SPONTANEOUS PNEUMOTHORAX

A patient diagnosed with pneumothorax is admitted to a specialized thoracic unit. Treatment includes three stages: expansion of the lung, determination of the causes of pneumothorax, and surgery.

Drainage of the pleural cavity is used to evacuate air and expand the lung. At the same time, diagnostic thoracoscopy is performed, which allows you to examine the chest organs and identify the cause of pneumothorax.

Spontaneous pneumothorax often recurs (in 30-50% of cases). Each episode increases the risk of the next relapse exponentially. Therefore, with spontaneous pneumothorax, surgery is indicated to prevent re-collapse of the lung.

Surgical treatment includes removal of the altered area of ​​the lung and pleurodesis – the formation of an fusion of the lung and chest wall, which protects the patient from relapses.

Today, video-assisted thoracoscopic surgery is the method of choice. The intervention is carried out through small punctures and is less traumatic. Rehabilitation after videothoracoscopic surgery for spontaneous pneumothorax is faster.

The duration of disability and return to normal life is reduced by 3-4 times. Also, thoracoscopy provides an excellent cosmetic effect, which is especially important for women.

The Oberig Universal Clinic has a powerful diagnostic base and the most modern video-assisted thoracoscopic equipment from the world’s leading manufacturers.

Make an appointment with highly qualified specialists of the Thoraco-Pulmonology Center by phone:

(044) 521 30 03

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