What is it about ?
Pneumothorax is the presence of air between the chest wall and the lung.
Each of the lungs is surrounded by a pleura. The pleura is a double membrane that covers the lung. One membrane lines the rib cage (the ribs and muscles between the ribs), it is called the parietal pleura (‘parietal’ for wall), the other membrane lines the lung, it is called the visceral pleura (the lung is a viscera). The term ‘the pleura’ is therefore used, either to speak of the double membrane, or to speak of only one of these two membranes.
When breathing, these two membranes slide against each other. They allow the lungs to fill up during inspiration, and to empty during expiration.
In the normal state, between the two membranes, there is a tiny bit of liquid, but there is no air.
If there is a leak in one of the membranes, air enters between the membranes. The lung partially or completely collapses, like a flat tire or a leaking balloon. This is called a pneumothorax.
Pneumothorax can happen spontaneously or be due to lung disease or trauma (injury).
A serious potential complication is tension pneumothorax. It usually occurs after trauma, mechanical ventilation, or resuscitation. The air penetrates without being able to escape and accumulates in the thorax. The pressure increases, and the organs there are compressed. Tension pneumothorax can be life threatening.
Where do we meet him?
Pneumothorax most often occurs between the ages of 20 and 40. The other risk factors are:
- smoking
- male
- lanky type (tall and lean)
- respiratory tract disease (e.g. asthma)
- altitude, scuba diving
- history of pneumothorax
- respiratory assistance in hospital
How to recognize it?
The main symptoms are pain on one side of the chest and a feeling of shortness of breath (dyspnea). These symptoms come on suddenly and get worse with breathing and exertion. Sometimes the pain shoots up into the shoulder and causes a dry cough.
How is the diagnosis made?
The doctor will ask you questions about the onset and progression of symptoms. Then he will auscultate your lungs. In the event of a collapsed lung (pneumothorax), the doctor hears less breath sounds on the affected side. Signs of severe tension pneumothorax are a lack of oxygen in the blood, blue lips, increased heart rate, low blood pressure …
Usually, a chest x-ray is needed to confirm the diagnosis.
What can you do ?
A pneumothorax can experience a very unfavorable course. It is therefore best to contact a doctor as soon as possible.
After a pneumothorax, a number of general tips are given:
- Stop smoking!
- Stay three months without flying and scuba diving.
- Go two months without playing sports.
- Go six weeks without heavy household chores and heavy lifting.
You can work in a seated position, but at first it is very important to rest. During the first few weeks, start gradually increasing your activities. A 5-10 minute walk is ideal. Each time, try to lengthen the walk a little. After two weeks, see if you can safely ride your bike again.
What can the doctor do?
Treatment depends on the cause and severity of the pneumothorax and your general condition. A tension pneumothorax always requires immediate treatment in hospital.
We can afford to observe how this progresses if it is a spontaneous pneumothorax less than 50% of the lung volume in a healthy person without shortness of breath. In this case, hospitalization is not necessary. Close follow-up is necessary, and marked improvement should be obtained after three or four days. Complete healing should be achieved within two weeks.
If the lung is completely collapsed, in a person with chronic lung disease or severe shortness of breath, more effective treatment is still needed. The air should be aspirated through a hollow needle or plastic drain. In the absence of healing, an endoscopic procedure is sometimes performed to try to close the air leak.
After pneumothorax, a recurrence occurs in almost half of people. If there is a recurrence, surgery may be considered to prevent another recurrence.
Want to know more?
- The pleura (drawing) – formationambulancier.fr
- Stop smoking. It’s possible – Tabacstop
- The radiography, here, Where to find on this page of Cliniques St Luc UCL
- Heimlich valve – Chest drain – CHU Montreal
Are you looking for more specialized help?
- Smoking Assistance Center (CAF®) – FARES – Respiratory Affections Fund
- Tobacco specialists – FARES – Respiratory Affections Fund
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