Pneumothorax

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Written by Li Tao
Pulmonology
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Pneumothorax is what disease?

Pneumothorax refers to the condition where gas enters the pleural cavity. Normally, the pleural cavity is a sealed space formed by the visceral pleura covering the lung surface and the parietal pleura on the chest wall. When gas enters the pleural cavity due to some reason, causing a state of gas accumulation, it is called pneumothorax. The causes of pneumothorax can be diseases of the lungs themselves or gas produced after the lungs and chest wall are injured by external forces. Typically, the condition occurs when the pleura near the lung surface ruptures, allowing gas to enter the pleural cavity, which is referred to as pneumothorax.

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Written by Wang Xiang Yu
Pulmonology
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Pneumothorax should be registered under which department?

What department should you register for pneumothorax? If pneumothorax occurs suddenly, the condition is generally severe with significant breathing difficulties. In such cases, we recommend prioritizing a visit to the emergency department. Once the emergency department receives the patient, they will immediately request a consultation with a thoracic surgeon or a respiratory specialist. If the patient requires surgery, such as thoracic closed drainage or other procedures, it is usually handled by a thoracic surgeon; if the patient only requires conservative treatment, they will likely be transferred to the respiratory department; if the patient's condition is critical, they might be admitted to the ICU.

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Written by Xia Bao Jun
Pulmonology
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Pneumothorax tracheal shift to which side?

When a patient suffers a pneumothorax, the trachea is displaced to the opposite side, and the heart is also shifted to the opposite side. In cases of left-sided pneumothorax, the heart's dullness boundary and the upper boundary of the liver during right-sided pneumothorax are both undetectable. There can be manifestations of subcutaneous emphysema in the neck, chest, and even the head and abdomen. The patient may exhibit diminished respiratory movements and a significant reduction or absence of breath sounds. When a small amount of air accumulates in the pleural cavity, weakened breath sounds on the affected side may be the only suspicious sign.

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Written by Li Jie
Orthopedics
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How to treat rib fracture and pneumothorax?

After a rib fracture, if a pneumothorax occurs, it is a very serious complication. There are three types of pneumothorax: closed pneumothorax, open pneumothorax, and tension pneumothorax. The simplest is the closed pneumothorax. If the area of lung compression in a closed pneumothorax is less than 30%, there is a hope for self-healing, and generally no special treatment is needed; if the lung compression exceeds 30%, it might be necessary to place a closed thoracic drainage tube to drain the air accumulating in the chest cavity, which may need to stay in the chest cavity for about a week. This is the treatment for a closed pneumothorax. If it is an open pneumothorax, it means there is an open wound on the chest. The treatment principle is to convert the open pneumothorax to a closed pneumothorax, which means sealing the wound, turning it into a closed pneumothorax, and then taking x-rays to assess the degree of lung compression. If the compression is significant, closed thoracic drainage is still necessary; if the compression is less severe, observation can continue. For a tension pneumothorax, it is the most severe type of pneumothorax and must be taken very seriously. Emergency placement of a closed thoracic drainage is recommended and must be handled promptly, as it could pose a life-threatening risk. In summary, once a pneumothorax occurs following rib fractures, it must be taken seriously. It is necessary to go to the hospital's thoracic surgery or orthopedic department for formal and timely treatment to prevent potentially severe consequences.

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Written by Han Shun Li
Pulmonology
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How long after a pneumothorax can the drainage tube be removed?

Pneumothorax occurs when the pleura ruptures and gas enters the pleural cavity. After the occurrence of pneumothorax, chest drainage by inserting a tube into the pleural cavity to remove the air is a common treatment. Generally, in most cases, after effective drainage for a few days, the lung can re-expand and the rupture can heal. Under these circumstances, it is common to clamp the drainage tube and observe for about two days. Then, a chest X-ray is re-examined and if there is no air, the tube can be removed. If air reappears after clamping, continued drainage is necessary. If the rupture does not heal and pneumothorax remains unresolved even after two weeks of drainage, and if the patient's physical condition allows, surgical treatment may be considered.

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Written by Han Shun Li
Pulmonology
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Spontaneous pneumothorax and the difference between pneumothorax.

Simply put, spontaneous pneumothorax is a type of pneumothorax. In the classification of pneumothorax, besides spontaneous pneumothorax, there are also traumatic pneumothorax and iatrogenic pneumothorax. Traumatic pneumothorax is caused by direct or indirect injury to the chest wall, while iatrogenic pneumothorax occurs during medical diagnosis and treatment. Spontaneous pneumothorax often involves underlying lung diseases, such as emphysema, lung bullae, tuberculosis, lung cancer, and pneumoconiosis. It can also occur in healthy individuals without obvious lung abnormalities, typically seen in tall, thin males of young to middle age.

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Written by Han Shun Li
Pulmonology
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Can pneumothorax recover by itself?

Pneumothorax is caused by a rupture of the pleura, allowing air to enter the pleural space. Patients often display symptoms such as coughing, chest pain, chest tightness, and shortness of breath. A lung radiograph can confirm the presence of a pneumothorax. Whether a patient with pneumothorax can recover on their own depends on the size of the pneumothorax. If it is a large pneumothorax, especially a communicative or tension pneumothorax, self-recovery is not possible, and treatment generally involves pleural puncture or pleural drainage tube placement. However, if the amount of air in the pneumothorax is small and the patient does not exhibit severe symptoms, then it is possible for the condition to resolve itself with bed rest.

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Written by Han Shun Li
Pulmonology
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Is pneumothorax the same as emphysema?

Pneumothorax and emphysema can both manifest symptoms such as chest tightness, difficulty breathing, and coughing. However, is pneumothorax the same as emphysema? Pneumothorax and emphysema are two different diseases. Simply put, pneumothorax is a pleural disease caused by a rupture of the pleura, while emphysema is a disease of the airways. When a lung is imaged for pneumothorax, the film shows lung compression. It is possible to see the external boundary of the compressed lung where pneumothorax is present, with no lung markings. In the case of emphysema, imaging shows that the thoracic cage is expanded, with widened intercostal spaces, and increased translucency in both lung lobes. Therefore, the differences between pneumothorax and emphysema are significant, and they are not the same disease.

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Written by Xia Bao Jun
Pulmonology
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Pneumothorax is caused by what?

Pneumothorax is caused by the entry of air into the pleural cavity, leading to a series of changes. Pneumothorax can be divided into spontaneous and traumatic pneumothorax. Spontaneous pneumothorax occurs without trauma or other causes, while traumatic pneumothorax is caused by direct or indirect trauma to the pleura. Spontaneous pneumothorax can be further categorized into primary and secondary pneumothorax. Patients with primary spontaneous pneumothorax do not have underlying lung disease, whereas secondary pneumothorax is a complication of lung disease, commonly seen in chronic obstructive pulmonary disease. Traumatic pneumothorax includes iatrogenic pneumothorax, which occurs during diagnostic and therapeutic procedures.

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Written by Han Shun Li
Pulmonology
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What position should be taken for pneumothorax?

Pneumothorax occurs when the pleura ruptures and gas enters the pleural cavity, often compressing the lung tissue. Patients may experience symptoms such as chest pain, chest tightness, and coughing. The choice of lying position for patients with pneumothorax depends on the severity of the pneumothorax and the degree of chest tightness. If the pneumothorax is mild and the symptoms are not obvious, the patient can lie flat. If there is significant chest tightness, a semi-recumbent position may be adopted. If the chest tightness is severe and the patient has significant difficulty breathing, they often assume a sitting position, frequently struggling to breathe, sweating profusely, and may even experience respiratory failure, requiring immediate attention.